Um Prior Auth Nurse

1 month ago


Los Angeles, United States MV Medical Management Full time

Utilizes decision-making and critical-thinking skills in the clinical review and determination of coverage for medically necessary health care services based on established hierarchy of criteria

Knowledge of California Children Services (CCS)

Knowledge of Health Plan DOFR's

Maintain Compliance and CMS regulatory standards

Follow UM Policies & Procedures

Experience in Healthcare/Managed Care

Work closely with UM team and Medical Director

LVN/RN Lic

2 Year Min in Managed Care

Pay: From $36.00 per hour

Expected hours: 40 per week

**Benefits**:

- 401(k)
- Dental insurance
- Health insurance
- Vision insurance

Physical setting:

- Outpatient

**Education**:

- Bachelor's (preferred)

**Experience**:

- Nursing: 3 years (required)

License/Certification:

- BLS Certification (preferred)
- RN OR LVN (required)

Work Location: In person


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