Job Summary
A company is looking for a Utilization Management LVN (Remote).
Key Responsibilities
- Conduct medical necessity reviews and coordinate authorizations for healthcare services
- Collaborate with clinical staff to ensure timely and accurate reviews while maintaining documentation
- Ensure compliance with regulatory and accreditation requirements and participate in team meetings and quality audits
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 familiar with EMR or healthcare systems
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