Clinical Nurse Specialist

4 weeks ago


Arcadia, California, United States UnitedHealth Group Full time

Job Summary

The Utilization Management Nurse, LVN, is a key member of our team at UnitedHealth Group. This role is responsible for medical necessity review of prospective referrals, ensuring that our patients receive the most appropriate care.

Key Responsibilities

  • Conduct thorough medical necessity reviews of referrals for inpatient, outpatient, home health, injectable medications, and DME/Orthotics/Prosthetics
  • Collaborate with healthcare professionals to ensure accurate and timely reviews
  • Develop and implement effective case management strategies to optimize patient outcomes

Requirements

  • Current LVN licensure
  • Strong clinical knowledge and analytical skills
  • Excellent communication and interpersonal skills


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