Licensed Vocational Nurse, Utilization Management

AltaMed Health Services Corporation; Montebello (CA); Hybrid; Full time

Job summary

An established industry player is seeking a Licensed Vocational Nurse for Utilization Management. In this pivotal role, you will review authorization requests and determine the medical necessity of treatments, ensuring quality care for all patients. This position not only allows you to utilize your clinical expertise but also offers a chance to grow within a supportive environment dedicated to community health. Join a team that values your passion for helping others while providing competitive compensation and comprehensive benefits. If you are ready to make a meaningful impact, this opportunity is perfect for you.

Benefits

Medical, Dental and Vision insurance

403(b) Retirement savings plans

Flexible Spending Accounts

Career Advancement & Development opportunities

Paid Time Off & Holidays

Tuition Reimbursement Program

Employee Referral Bonus Program

Pet Care Insurance

Qualifications

• Minimum 2 years of managed care experience required.
• Current LVN license issued by California is mandatory.

Responsibilities

• Review authorization requests for medical necessity and efficiency.
• Determine appropriateness of inpatient and outpatient services.

Skills

Managed Care Experience

Medical Necessity Review

Authorization Requests Review

BLS Certification

Education

Graduated from accredited LVN school

Job description

Licensed Vocational Nurse, Utilization Management

Licensed Vocational Nurse, Utilization Management

Apply remote type Hybrid locations Montebello, CA 90640 time type Full time posted on Posted Today job requisition id JR5313

Grow Healthy

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.

Job Overview

The LVN, Utilization Management Nurse position will provide routine review of authorization requests from all lines of business using respective national/state, health plans, and nationally recognized guidelines. Responsible for reviewing proposed hospitalization, home care, and inpatient/outpatient treatment plans for medical necessity and efficiency with coverage guidelines. The UM Nurse determines the medical appropriateness of inpatient and outpatient services following the evaluation of medical guidelines and benefit determination.

Minimum Requirements

• Graduated from an accredited LVN school with a current LVN license issued by the State of California Vocational Nursing.
• Minimum of 2 years of managed care experience is required.
• BLS Certification is required.

Compensation

$31.05 - $38.82 hourly

Compensation Disclaimer

Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.

Benefits & Career Development

• Medical, Dental and Vision insurance
• 403(b) Retirement savings plans with employer matching contributions
• Flexible Spending Accounts
• Commuter Flexible Spending
• Career Advancement & Development opportunities
• Paid Time Off & Holidays
• Paid CME Days
• Malpractice insurance and tail coverage
• Tuition Reimbursement Program
• Corporate Employee Discounts
• Employee Referral Bonus Program
• Pet Care Insurance

Job Advertisement & Application Compliance Statement

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

Equal Opportunity Employer

AltaMed Health Services Corporation is committed to providing equal employment opportunities for all qualified individuals. We strictly prohibit discrimination in employment based on race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin, age, medical condition, physical or mental disability, military or protected veteran status, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical conditions, genetic information, or any other characteristic protected by local, state, or federal law, ordinance, or regulation.

We are committed to promoting equality and inclusivity beyond our recruitment and hiring processes. We aim to create a respectful, valued, and inclusive workplace through training, advancement opportunities, and access to resources and support. We focus on fostering a diverse workforce because it enriches our organization and improves our ability to effectively serve our clients and community. We encourage individuals from all backgrounds to apply and join us in our mission to create a positive impact.