Healthcare Case Manager

3 weeks ago


Orange, California, United States Kinetic Personnel Group Full time

Job Title: Medical Service Coordinator

About the Job

We are seeking a highly skilled Medical Service Coordinator to join our team at Kinetic Personnel Group. As a Medical Service Coordinator, you will play a critical role in reviewing and processing requests for medical services from healthcare professionals, clinical facilities, and ancillary providers.

Responsibilities
  • Review requests for medical appropriateness and verify specialty referrals, diagnostic testing, and other services.
  • Process requests via telephone or fax using established clinical protocols to determine medical necessity.
  • Screen requests for the Medical Director review, gather pertinent medical information, and follow up with requesters regarding the Medical Director's decision.
  • Document follow-up in the utilization management system and complete required documentation for data entry.
Requirements
  • A current, unrestricted Licensed Vocational Nurse (LVN) license to practice in California is required.
  • Three years of nursing experience and one year as a Clinical Nurse Reviewer are required.
  • One year of Utilization Management/Prior Authorization Review experience is also required.
What We Offer

This full-time, temporary position offers a competitive hourly rate of $50-$65 per hour, depending on experience.



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