Nurse Review LVN (Prior Authorization) New

Location: Orange, CA

Salary: $37.00 USD Hourly - $55.00 USD Hourly

Description: Judge Healthcare is currently seeking a Case Manager LVN (Prior Authorization) in Orange, CA!!

Job Details: 6 month contract (W2, Weekly Pay, Benefits/401K Available)

Location: *FULLY ON SITE* , Orange, CA

Hours: Monday-Friday 8am-5pm

Compensation: Competitive and based on experience

You will be responsible for providing case management intervention on behalf of members with short term, stable and predictable courses of illnesses. You would also be responsible for answering the medical appropriateness, quality and cost effectiveness of proposed hospital/medical/surgical services in accordance with established criteria.

Responsibilities

• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
• Reviews requests for medical appropriateness.
• Verifies and processes specialty referrals, diagnostic testing, outpatient procedures, home health care services and durable medical equipment and supplies via telephone or fax using established clinical protocols to determine medical necessity.
• Screens requests for the Medical Director’s review, gathers pertinent medical information prior to submission to the Medical Director, follows up with the requester by communicating the Medical Director’s decision and documents follow-ups in the utilization management system.
  
  

Qualifications & Requirements:

• HS Diploma required
• Current CA LVN licensed required.
• 3 years of nursing experience required, 1 year of which must be as a nurse reviewer
• 1+ year concurrent review experience preferred.
• Bilingual is a plus!
  
  

Interested and qualified candidates are encouraged to apply directly to the jobs link on this posting!

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Contact: wdpqm6u@yg2p2v2pfhp.com

This job and many more are available through The Judge Group. Find us on the web at www.judge.com