LPN / LVN Case Manager for Equiliem

3 days ago


Orange, California, United States Equiliem Full time
Job Description:
Equiliem is seeking a skilled LPN / LVN to fill a challenging Case Management position. As a key member of our team, you will be responsible for reviewing and processing requests for medical services from health professionals and clinical facilities.

This dynamic role requires strong problem-solving skills, excellent communication abilities, and the ability to work in a fast-paced environment. You will utilize CalOptima Health's medical criteria, policies, and procedures to authorize referral requests, ensuring accurate and efficient decision-making.

Your responsibilities will include:
• Reviewing requests for medical appropriateness
• Verifying and processing specialty referrals, diagnostic testing, outpatient procedures, home health care services, and durable medical equipment and supplies
• Screening requests for the Medical Director's review and following up with requesters on decisions
• Completing required documentation for data entry into the utilization management system

To excel in this role, you should possess:
• A current, unrestricted Licensed Vocational Nurse (LVN) license to practice in California
• 3 years of nursing experience, including 1 year as a nurse reviewer
• 1 year of utilization management/prior authorization review experience
• Strong organizational and time management skills, with the ability to work independently and collaboratively as part of a team
• Excellent communication and problem-solving skills, with the ability to adapt to changing priorities and deadlines

We offer a competitive salary range of $37-55 per hour, depending on experience. This position is ideal for individuals who thrive in dynamic environments and are passionate about delivering exceptional patient care.

  • Orange, California, United States Equiliem Full time

    Equiliem is seeking a highly skilled Case Management Specialist to join our team in Orange, California. This is a fantastic opportunity for a licensed vocational nurse (LVN) with experience in prior authorization review and medical case management to work on a local contract basis.As a Case Management Specialist, you will play a critical role in reviewing...

  • Medical Case Manager

    4 hours ago


    Orange, California, United States Equiliem Full time

    We are seeking a skilled Medical Case Manager to join our team at Equiliem in Orange, California.This is a local contract job with 40 hours per week, 8 hours a day, 5x8 hrs shift.The estimated salary for this role is $37-55 per hour.As a Medical Case Manager, you will be responsible for reviewing and processing requests for authorization and notification of...


  • Orange, California, United States Equiliem Full time

    Equiliem is seeking a highly skilled LPN Case Manager for a local contract job in Orange, California.Job Overview:The Medical Case Manager will be responsible for reviewing and processing requests for authorization and notification of medical services from health professionals, clinical facilities, and ancillary providers.The incumbent will utilize CalOptima...


  • Orange, California, United States Equiliem Full time

    About the RoleWe are seeking a highly skilled Clinical Case Reviewer to join our team at Equiliem Healthcare. This is a unique opportunity to work in a fast-paced environment, utilizing your expertise in healthcare utilization management.Key ResponsibilitiesReview medical requests for appropriateness and quality, ensuring consistency with established...


  • Orange, California, United States Equiliem Full time

    We are seeking a highly motivated and experienced Clinical Appeals Specialist to join our team at Equiliem Healthcare. This role involves participating in managing medical appeals and state hearing reviews for all lines of business, including handling expedited and standard requests.The ideal candidate will ensure appeals and state hearing requests are...


  • Orange, California, United States Regal Medical Group, Inc. Full time

    Job OverviewWe are seeking an Inpatient LVN Case Manager to join our team at Regal Medical Group, Inc. in Orange County. As a key member of our healthcare team, you will be responsible for assessing, treating, and managing patient care during their hospital stay.


  • Orange, California, United States LanceSoft Full time

    Job TitleLPN Case Management PositionAbout LanceSoftLanceSoft is a certified MBE and Woman-Owned organization established in 2000. We specialize in providing medical professionals to various healthcare facilities across the United States.Job DescriptionWe are seeking a skilled LPN for a full-time case management position in Orange, California. This...


  • Orange, California, United States LanceSoft Full time

    LanceSoft, a recognized leader in healthcare staffing, is seeking a skilled LPN/LVN Case Manager to join their team for a short-term contract opportunity in the Orange County area. This role involves providing case management services for patients with complex needs, requiring strong communication and problem-solving skills.The ideal candidate will possess a...


  • Orange, California, United States TotalMed Case Management Staffing Full time

    TotalMed Case Management Staffing is a leading provider of travel nursing solutions, dedicated to delivering exceptional care and support to our clients and healthcare professionals.About the RoleWe are seeking an experienced Registered Nurse with a specialization in Case Management to join our team for a 13-week assignment in Orange, California. As a Case...


  • Orange, California, United States TotalMed Case Management Staffing Full time

    TotalMed Case Management Staffing is seeking a highly skilled travel nurse to join their team as a Case Manager. With a strong background in healthcare, this individual will be responsible for assessing patient needs, developing care plans, and coordinating with other healthcare professionals to ensure seamless patient care.This role offers an exciting...


  • Orange, California, United States TotalMed Case Management Staffing Full time

    Unlock Your Potential as a Travel NurseWe are seeking a highly skilled and dedicated Registered Nurse to join our team as a travel nurse in Orange, California. As a case manager-registered nurse, you will have the opportunity to make a meaningful impact on the lives of patients while exploring new destinations.About TotalMed Case Management Staffing:TotalMed...


  • Orange, California, United States TotalMed Case Management Staffing Full time

    We are seeking a dedicated and compassionate Registered Nurse (RN) for our case management team. This exciting opportunity is perfect for individuals who are passionate about delivering exceptional patient care and making a meaningful difference in the lives of others.About TotalMed Case Management StaffingTotalMed Case Management Staffing is a leading...


  • Orange, California, United States TotalMed Case Management Staffing Full time

    TotalMed Case Management Staffing is a leading healthcare staffing agency seeking a highly skilled Registered Nurse to fill a Case Management position in Orange, California.About the JobThis 13-week assignment offers the opportunity to work with a dynamic team and contribute to providing exceptional patient care. As a Registered Nurse in this role, you will...


  • Orange, California, United States Regal Medical Group, Inc. Full time

    Job Summary:Regal Medical Group, Inc. is seeking a dedicated and compassionate Patient Care Navigator to join our team. As an Inpatient Case Manager, you will play a crucial role in ensuring the highest level of care for our patients during their hospitalization.About Us:We are one of the fastest growing Independent Physician Associations in Southern...


  • Orange, California, United States VitalHire Full time

    Job OverviewVitalHire is a healthcare organization seeking an experienced travel nurse RN to fill a challenging case management position in California.About the RoleThis 13-week opportunity offers a unique blend of skills and experience, with a focus on delivering exceptional patient care. As a vital member of our team, you will be responsible for managing...


  • Orange, California, United States Kaiser Permanente Full time

    About the RoleWe are seeking a highly skilled Case Management RN Specialist to join our team at Kaiser Permanente in Orange, California. This is an excellent opportunity to work with a talented group of professionals who share your passion for delivering exceptional patient care.Job SummaryThis RN Case Manager will play a critical role in managing the...


  • Orange, California, United States talent4health Full time

    About the JobTalent4Health is seeking a highly motivated and experienced Pediatric Medical Case Manager to join our team. As a member of our case management team, you will play a critical role in ensuring the health and well-being of our pediatric members.Job SummaryThe successful candidate will be responsible for providing intensive case management services...


  • Orange, California, United States ALOIS Healthcare Full time

    Alois Healthcare is seeking a travel nurse case manager to join their team in Orange, California. This 13-week contract offers an exciting opportunity for a skilled RN to work in a dynamic and supportive environment.Job SummaryWe are looking for a dedicated and compassionate nurse case manager who will act as a patient advocate, ensuring that patients...


  • Orange, California, United States LHC Group Full time

    LHC Group is a leading provider of home health care services, seeking a highly skilled and dedicated LPN/LVN to join our team as a Home Health Patient Care Coordinator. This role plays a critical part in ensuring the continuity of high-quality care to our patients, working closely with a team of healthcare professionals to coordinate patient care.Job...


  • Orange, California, United States Nurse First Full time

    Job Title: Travel Nursing Case ManagerWe are seeking a skilled travel nurse to join our team as a Case Management RN. This is an exciting opportunity for a dedicated and compassionate nurse to provide exceptional patient care while exploring new destinations.About the Role:Case Management RN position available in Orange, California13 weeks contract with 40...