Highlights
Education & Requirements Two (2) years or more case management, utilization management in managed care setting or related experience in a health care delivery setting Experience in an HMO or experience in managed care setting preferred. Minimum possession of an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians required.
Numbers & Facts
| Location | Rancho Cucamonga, CA |
| Industry | Staffing/Employment Agencies |
| Company Size | 2,000 to 2,499 employees |
| Year Founded | 2000 |
| Website | http://www.lancesoft.com/ |
Description
Title: Temporary Grievance & Appeals Nurse (LVN)
Work location: Rancho Cucamonga, CA 91701
Payrate: $30.72 /HR
Duration: Six-month Assignment
Requirements:
Responsibilities:
Qualifications:
Education & Requirements
Work location: Rancho Cucamonga, CA 91701
Payrate: $30.72 /HR
Duration: Six-month Assignment
Requirements:
- Standard Background & Drug Screen
- +Professional license verification
- + MVR (driving record)
Responsibilities:
Qualifications:
Education & Requirements
- Two (2) years or more case management, utilization management in managed care setting or related experience in a health care delivery setting
- Experience in an HMO or experience in managed care setting preferred
- High school diploma or GED required
- Associate s degree from an accredited institution preferred
- Minimum possession of an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians required
- Must have a valid California Driver's License
- Working knowledge and understanding of:
- Member and Provider legal rights to access the grievance and appeals resolution process, within the respective Provider Organization, DHCS, DMHC, and Client and IEHP
- Outside agencies and resources such as CCS, Client, DMHC, or DHCS
- Regulatory guidelines surrounding grievances and appeals per Client, DHCS, and DMHC and NCQA
- Microcomputer applications: spreadsheet, database, and word processing. Excellent written and verbal communication skills
- Proven ability to:
- Demonstrate critical thinking and strong problem-solving capability
- Demonstrate a commitment to incorporate LEAN principles into daily work
- Possess strong attention to detail
- Prioritize work to ensure adherence to project deadlines
- Effectively escalate issues as identified, following established protocols
- Maintain a positive attitude and ability to work in a team setting
About Company
We are a $125 Million, NMSDC-certified Minority & Woman owned Workforce Solutions Company headquartered in the DC metro area with presence across US with global presence - Canada, Mexico, India, UK, Malaysia, Indonasia, Hongkong, Singapore, UAE. We are specialized in providing Workforce Solutions, SOW project delivery, Engineering Solutions, Creative Services. We currently support 100+ Fortune companies globally and across multiple industry segments. We are currently supporting several massive programs across industry segment nationally/globally (Intel, Ally, AMD, QUALCOMM, Morgan Stanley, Kraft/ Mondelez, MNP, Amdocs, Dell, SanDisk, Medtronic, Becton Dickinson, GE, Lockheed Martin, UTC, L-3 Communications, Caterpillar, BMW, Mercedes Benz, National Grid, Dominion, Energy Future Holdings, PSEG, 3M, Fidelity, Aetna, Humana, Johnson & Johnson, Pfizer, Merck etc).
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, identity, national origin, disability, or protected veteran status.