Remote Utilization Review Nurse – CA Licensed (LVN/RN)

Astrana Health; California (MO); Remote; USD 41,328 - 46,838; Full time

Job summary

A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying medical services based on established criteria. Competitive hourly compensation ranges from $30.00 to $34.00. Join our dedicated team committed to putting patients first.

Qualifications

• Experience in outpatient UM; case management experience alone is not sufficient.
• Strong collaborative skills with colleagues and leadership.

Responsibilities

• Review outpatient medical services for medical necessity.
• Complete prior authorization and retrospective review.
• Maintain state and federal regulation knowledge.

Skills

Outpatient Utilization Management

Interpersonal Skills

Experience with Microsoft Word

Experience with Microsoft Excel

Experience with Microsoft Outlook

Education

Active LVN license in California

Job description

A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying medical services based on established criteria. Competitive hourly compensation ranges from $30.00 to $34.00. Join our dedicated team committed to putting patients first.