Licensed Practical Nurse
3 weeks ago
Location: Columbia, SC 29229 (Remote after training) Duration: 3+ Months (Possible temp to hire) Job Description: Hours/Schedule: Monday - Friday, 8:30am-5pm. Onsite 1-2 weeks, then will work remote. Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. Responsibilities: May provide any of the following in support of medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge payment determination. Monitors process's timeliness in accordance with contractor standards. Performs authorization process, ensuring coverage for appropriate medical services within benefit and medical necessity guidelines. Utilizes allocated resources to back up review determination. Reviews interdepartmental requests and medical information in a timely/effective manner in order to complete utilization process. May conduct/perform high dollar forecasting research and formulate overall patient health summaries with future health prognosis and projected medical costs. Performs screenings/assessments and determines risk via telephone. Reviews/determines eligibility, level of benefits, and medical necessity of services and/or reasonableness and necessity of services. Provides education to members and their families/caregivers. Reviews first level appeal and ensures utilization or claim review provides thorough documentation of each determination and basis for each. Conducts research necessary to make thorough/accurate basis for each determination made. Educates internal/external staff regarding medical reviews, medical terminology, coverage determinations, coding procedures, etc. in accordance with contractor guidelines. Responds accurately and timely with appropriate documentation to members and providers on all rendered determinations. Participates in quality control activities in support of the corporate and team-based objectives. Participates in all required training. Experience: 2 years clinical experience. Skills: Working knowledge of word processing software. Good judgment skills. Demonstrated customer service and organizational skills. Analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion. Ability to remain in a stationary position and operate a computer. Education: Associate Degree - Nursing OR Graduate of an Accredited School of Licensed Practical Nursing or Licensed Vocational Nursing and Active, unrestricted LPN/LVN licensure. About US Tech Solutions:US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com. US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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Licensed Practical Nurse
12 hours ago
Columbia, United States PruittHealth Full timeLICENSED PRACTICAL NURSE Hiring for 7a-7p and 7p-7a, full-time and part-time shifts available! Join the PruittHealth family, where the health and safety of our workforce is our top priority! We're not only committed to your career, we're committed to the health and safety of all our nurses. Now is a great time to make a change and join one of the leading...
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Licensed Practical Nurse
3 weeks ago
Columbia, United States Valor Health Full timeLicensed Practical Nurse Columbia, TN (+S+James+Campbell+Blvd.+Columbia+TN+USA+38401) • Licensed Practical Nurse Apply Job Type Full-time Description Valor Healthcare is looking for a passionate Licensed Practical Nurse to join our team at the Community Based Outpatient Clinic (CBOC) in Columbia, TN. In exchange for your dedication and experience, we are...
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Licensed Practical Nurse
6 days ago
Columbia, United States BRIA Full timeDescription: Join us at the Nexus of care and compassion.Licensed Practical Nurse (LPN) Benefits:Growth from withinNext day pay availableEmployee rewards programTuition reimbursementBCBS healthcare coverage401kLicensed Practical Nurse (LPN) Responsibilities:As a licensed practical nurse (LPN), you will provide direct care to residents.You will supervise...
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Licensed Practical Nurse
6 days ago
Columbia, United States BRIA Full timeDescription: Join us at the Nexus of care and compassion.Licensed Practical Nurse (LPN) Benefits:Growth from withinNext day pay availableEmployee rewards programTuition reimbursementBCBS healthcare coverage401kLicensed Practical Nurse (LPN) Responsibilities:As a licensed practical nurse (LPN), you will provide direct care to residents.You will supervise...
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Licensed Practical Nurse
7 days ago
Columbia, United States BRIA Full timeDescription:Join us at the Nexus of care and compassion.Licensed Practical Nurse (LPN) Benefits:Growth from withinNext day pay availableEmployee rewards programTuition reimbursementBCBS healthcare coverage401kLicensed Practical Nurse (LPN) Responsibilities:As a licensed practical nurse (LPN), you will provide direct care to residents.You will supervise...
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Licensed Practical Nurse LPN
3 weeks ago
Columbia, United States Avalon Health Care Management Inc. Full timeAvalon Health Care - E. Roy Stone, Jr. Veterans Pavilion is hiring for PRN Licensed Practical Nurse LPN! Effective July 1, the E. Roy Stone Veterans Pavilion on the CM Tucker campus, will transfer to the SC Department of Veteran Affairs from the SC Department of Mental Health. Avalon Health Care, a privately operated company experienced in the long-term care...
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Licensed Practical Nurse
1 week ago
Columbia, United States Interim HealthCare Full timeSalary Info: $55000.00 - $65000.00/Yearly Join Interim HealthCare, the nations first home care company recently recognized on Forbes Americas Best Large Company List and transform your career with a role that offers more than just a paycheck. We're currently seeking compassionate and skilled Home Health LPNs to provide personalized care in patients' homes....
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Licensed Practical Nurse
6 days ago
Columbia, United States Interim HealthCare Full timeSalary Info: $31.00 - $32.50/Hourly Competitive Pay: $31.00 - $32.50 / per visit Join Interim HealthCare, the nations first home care companyrecently recognized on Forbes Americas Best Large Company Listand transform your career with a role that offers more than just a paycheck. We're currently seeking compassionate and skilled Home Health LPNs to provide...
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Licensed Practical Nurse
7 days ago
Columbia, United States Interim HealthCare Full timeSalary Info: $31.00 - $32.50/HourlyCompetitive Pay:$31.00 - $32.50 / per visitJoin Interim HealthCare, the nation's first home care company —recently recognized onForbes' America's Best Large Company List —and transform your career with a role that offers more than just a paycheck. We're currently seeking compassionate and skilledHome Health LPNsto...
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Licensed Practical Nurse
2 weeks ago
Columbia, United States THE VILLA AT BLUE RIDGE Full timeTHE VILLA AT BLUE RIDGE - THE VILLA AT BLUE RIDGE, located in Columbia, Missouri is currently seeking a Licensed Practical Nurse (LPN) to join our team.Licensed Practical Nurse (LPN) Duties and Responsibilities:Provides nursing care to patients as assignedAdministers and records medications and treatments as assignedReinforce supports and provides health...
