California Licensed Utilization Review Nurse

Job Summary

A company is looking for a UM Review Nurse - LVN.

Key Responsibilities

• Complete prior authorization/retrospective review of medical services
• Refer cases to Medical Directors as necessary
• Maintain knowledge of regulations and comply with internal policies

Required Qualifications

• Active and unrestricted LVN license in California
• 1+ years of outpatient utilization management experience
• Experience with Microsoft applications such as Word, Excel, and Outlook
• Preferred two years of health plan, IPA, or MSO experience
• Open availability for scheduling between 8 AM - 8 PM, Monday through Sunday