LVN Utilization Management Nurse Reviewer

Job Summary

A company is looking for an LVN for Utilization Management.

Key Responsibilities:

• Perform precertification and prior approvals for Medicaid clients
• Conduct utilization review of outpatient procedures and ancillary services
• Collaborate with healthcare providers to ensure high-quality and cost-effective care delivery

Required Qualifications:

• Current and unrestricted compact vocational nurse license
• High School Diploma or equivalent
• Minimum of three years of direct clinical patient care experience
• Minimum of one year of experience with medical management activities in a managed care environment
• Knowledge of managed care principles and health care resources within the community