LPN Authorization Coordinator (Utilization Management)

Sentara Health Plans; Norfolk, Northern (VA, KY); Hybrid; USD 50,000 - 70,000; Full time

Benefits offered by this job

Medical insurance

Dental & Vision coverage

Paid Time Off

Parental leave

401k with employer match

Job summary

Sentara Health Plans in Norfolk, VA seeks an Authorization Coordinator to review clinical information from physicians to determine if services should be authorized, ensuring data supports decisions. This role analyzes data to ensure services are authorized per clinical protocols and validates member benefits before authorization.

The position requires a High School Diploma and LPN license with 3 years of related experience; utilization management and Milliman experience are preferred, along with

Qualifications

• High School Diploma required.
• LPN license required.
• 3 years of related experience required.
• Utilization Management experience preferred.
• Diagnostic Imaging experience preferred.
• Microsoft Office (Word, Excel, Outlook) preferred.
• Milliman experience preferred.

Responsibilities

• Review clinical information from physicians to determine authorization.
• Analyze data to ensure services are authorized per clinical protocols.
• Validate member benefits and enrollment data prior to authorization.

Skills

Utilization Management

Diagnostic Imaging

Microsoft Office

Milliman

Education

High School Diploma

Licensed Practical Nurse (LPN)

Tools

Milliman

Microsoft Office Suite

Job description

Sentara Health Plans in Norfolk, VA seeks an Authorization Coordinator to review clinical information from physicians to determine if services should be authorized, ensuring data supports decisions. This role analyzes data to ensure services are authorized per clinical protocols and validates member benefits before authorization.

The position requires a High School Diploma and LPN license with 3 years of related experience; utilization management and Milliman experience are preferred, along with