Remote Inpatient Utilization Nurse (LPN)

Alignment Health; Yuma (AZ); Remote; USD 65,000 - 95,000; Full time

Job summary

Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse, you will assist patients through the continuum of care in collaboration with the patient’s primary care physician, facility case manager, discharge planner and contracted ancillary providers as needed.

Schedule: Monday - Friday, 8:00 AM - 5:00 PM Pacific Time. Requires LVN or RN license (CA or willing to obtain in other states) and 3+ years of case management

Qualifications

• Minimum 3 years of general case management skills.
• Two years using Milliman Care Guidelines to justify inpatient vs observation stay.
• Two consecutive years in a managed care setting as an inpatient case manager.
• Active LVN or RN license in California (Non-Compact).

Responsibilities

• Performs reviews of inpatients with complex medical and social problems.
• Generates referrals to contracted ancillary service providers and community agencies.
• Communicates with patients and families and coordinates with physicians and providers.
• Monitors and reports progress to Medical Director and UM Manager.

Skills

Case management

Critical thinking

Report analysis

Communication

Education

Associate's or Bachelor's Degree

LVN/RN license (CA)

Job description

Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse, you will assist patients through the continuum of care in collaboration with the patient’s primary care physician, facility case manager, discharge planner and contracted ancillary providers as needed.

Schedule: Monday - Friday, 8:00 AM - 5:00 PM Pacific Time. Requires LVN or RN license (CA or willing to obtain in other states) and 3+ years of case management