California Licensed Bilingual LVN

Job Summary

A company is looking for a Bilingual LVN Utilization Management Nurse.

Key Responsibilities

• Facilitate pre-certification of medical services and post-service review of medical claims
• Collaborate with care management nurses to coordinate medically necessary care
• Assist in the process of Disease/Health Management by entering participant information and educating members

Required Qualifications

• Completion of an accredited nursing program with an Associate Degree in Nursing
• Vocational Nurse license in the State of California with two years of experience in health insurance preferred
• Strong clinical assessment knowledge and understanding of medical practice and health insurance claims
• Proficient knowledge of coding books and medical terminology
• Previous experience in utilization review, medical review, and case management activities preferred