Licensed Vocational Nurse
1 week ago
This position is responsible for implementing and coordinating all utilization management functions relating to pre-certification of outpatient services. The LVN Case Manager in this capacity is responsible for coordinating authorizations and notifications.
Key Responsibilities- Clear understanding of managed healthcare and utilization management principles
- Possess knowledge of applicable regulatory standards and ability to prepare for audits
- Ability to maintain compliance and turnaround time standards for all UM assignments
- Provide excellent customer service to members
- Communicate effectively with a professional attitude
- Be responsible and accountable for all assignments and deliverables
- Follow company policies, procedures, and directives
- Interact in a positive and constructive manner
- Prioritize and multitask in a fast-paced work environment
- Inputs all information in referral system and ensures accuracy
- Process referral authorization from providers in a timely manner using established protocols
- Faxes back to requested provider information needed if not received
- Gathers and assesses relevant documentation to compare with MCG/UM Criteria
- Communicates with Utilization Physician Reviewer for follow-up and resolution of authorization referrals
- Interacts effectively with providers, physician reviewers, and other departments using strong verbal and written communication skills
- Applies UM criteria appropriately to authorization requests
- Apply Timeliness Standards to processing of referrals (ICE Timelines Grids)
- Review and update authorizations as needed
- Requests medical records or other information as needed to justify referrals
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Licensed Vocational Nurse
1 month ago
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Licensed Vocational Nurse
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Licensed Vocational Nurse
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Licensed Vocational Nurse
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Licensed Vocational Nurse
3 weeks ago
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Licensed Vocational Nurse
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Licensed Vocational Nurse
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Licensed Vocational Nurse
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Licensed Vocational Nurse
1 month ago
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Licensed Vocational Nurse
1 month ago
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Licensed Vocational Nurse
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Licensed Vocational Nurse
4 weeks ago
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Licensed Vocational Nurse
1 week ago
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Licensed Vocational Nurse
3 weeks ago
Dallas, Texas, United States Accident Centers of Texas Full timeJob Title: Part-Time Licensed Vocational Nurse (LVN)Accident Centers of Texas is a multidisciplinary practice providing physical therapy and chiropractic services to personal injury patients. We are seeking a Part-Time Licensed Vocational Nurse (LVN) to join our pain management clinic in Dallas.Job Responsibilities:Provide routine care for patients,...
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Licensed Vocational Nurse
1 month ago
Dallas, Texas, United States Accident Centers of Texas Full timeJob Title: Part-Time Licensed Vocational Nurse (LVN)Accident Centers of Texas is a multidisciplinary practice providing physical therapy and chiropractic services to personal injury patients.Job Summary:We are seeking a Part-Time Licensed Vocational Nurse (LVN) to join our pain management clinic in Dallas. The successful candidate will provide routine care...
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Licensed Vocational Nurse
4 weeks ago
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Licensed Vocational Nurse
1 month ago
Dallas, Texas, United States Evergreen Life Services Texas Full timeJob SummaryWe are seeking a skilled Licensed Vocational Nurse to join our team at Evergreen Life Services Texas. As a key member of our healthcare team, you will be responsible for providing high-quality nursing care to our clients, ensuring their health and well-being in a safe and therapeutic environment.Key ResponsibilitiesContribute to the planning and...
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Licensed Vocational Nurse
4 days ago
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LVN - Licensed Vocational Nurse
2 weeks ago
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