eNLC Licensed Utilization Management LVN

Job Summary

A company is looking for a Utilization Management LVN (Remote).

Key Responsibilities

• Conduct medical necessity reviews and assess appropriateness of care
• Process prior authorization requests and collaborate with clinical staff
• Maintain documentation and ensure compliance with regulatory requirements

Required Qualifications

• Active and unrestricted LVN license in an eNLC state
• 3+ years of nursing experience
• 1+ year of Utilization Management experience
• Knowledge of UM guidelines and clinical documentation standards
• Proficient in Microsoft Office and EMR or healthcare systems