California Licensed Utilization Management NurseVirtualVocations • Toledo, Ohio, United States
California Licensed Utilization Management Nurse
VirtualVocations • Toledo, Ohio, United States
23 days ago
Job type
- Full-time
Job description
A company is looking for a Utilization Management Nurse - LVN (Work from Home).
Key Responsibilities
Perform medical necessity reviews for assigned members
Collaborate with the Medical Director on adverse determination notices
Ensure timely discharge planning and communication with care teams
Required Qualifications, Training, and Education
Associate's degree in Nursing, preferred
Minimum 2 years of experience in medical management clinical functions
Working knowledge of MCG, InterQual, and NCQA standards
Active License as a Licensed Vocational Nurse (LVN) in California
Certification in Managed Care Nursing (CMCN) preferred
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Utilization Management Nurse • Toledo, Ohio, United States
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