US
0 suggestions are available, use up and down arrow to navigate them
What job do you want?

Prior Authorization Registered LVN - Remote job in Long Beach at Vivo HealthStaff

Create Job Alert.

Get similar jobs sent to your email

List of Jobs

Apply to this job.
Think you're the perfect candidate?
Prior Authorization Registered LVN - Remote at Vivo HealthStaff

Prior Authorization Registered LVN - Remote

Vivo HealthStaff Long Beach, CA (On Site) Full-Time

Vivo HealthStaff is hiring a Prior Authorization LVN for a health plan based in Southern California.

Position Details:

Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization requests.

  • Perform telephonic review of prior authorization requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations
  • Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings
  • Collaborate with various staff within provider networks and case management team electronically or telephonically to coordinate member care
  • Educate providers on utilization and medical management processes
  • Provide clinical knowledge and act as a clinical resource to non-clinical team staff
  • Enter and maintain pertinent clinical information in various medical management systems


Requirements:

- LVN Certificate

- CA Registered LVN

- Located within 50 miles of Los Angeles, CA

- 3 years of experience in Prior Authorization/Utilization Review

Recommended Skills

  • Electronic Medical Record
  • Nursing
  • Cardiopulmonary Resuscitation
  • Life Support
  • Automated External Defibrillator
  • Basic First Aid
Apply to this job.
Think you're the perfect candidate?

Help us improve CareerBuilder by providing feedback about this job:

Job ID: g34rjb1

CareerBuilder TIP

For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Learn more.

By applying to a job using CareerBuilder you are agreeing to comply with and be subject to the CareerBuilder Terms and Conditions for use of our website. To use our website, you must agree with the Terms and Conditions and both meet and comply with their provisions.