Hybrid LVN: Prior Authorization - Utilization Management

Central California Alliance for Health; United States; Hybrid; USD 87,000 - 95,000; Full time

Benefits offered by this job

Medical plan

Dental plan

Vision plan

Paid time off

12 holidays per year

401(a) retirement plan

457 plan

Wellness program

EV charging

Job summary

Central California Alliance for Health is seeking a licensed vocational nurse for a full‑time temporary role in utilization management. You will review prior authorization requests and apply state regulations to ensure timely, evidence‑based care under the supervision of an RN.

Hybrid work is available; the assignment runs through 12/31/26 with potential extensions. Some in‑office presence may be required, and compensation aligns with Zone 1/2 pay scales for the California Central Valley region.

Qualifications

• Knowledge of MCG Care Guidelines in review determination process.
• Medi‑Cal and related policy and benefits‑related Title 22 regulations.
• Principles and practices of clinical nursing.

Responsibilities

• Ensure that prior authorization requests are completed in a timely fashion to meet contractual requirements and ensure reviews use evidence-based standards.

Skills

MCG Guidelines

Medi-Cal policy

Clinical nursing

Education

Licensed Vocational Nurse (CA)

High school diploma or equivalent

Job description

Central California Alliance for Health is seeking a licensed vocational nurse for a full‑time temporary role in utilization management. You will review prior authorization requests and apply state regulations to ensure timely, evidence‑based care under the supervision of an RN.

Hybrid work is available; the assignment runs through 12/31/26 with potential extensions. Some in‑office presence may be required, and compensation aligns with Zone 1/2 pay scales for the California Central Valley region.