Remote Utilization Review Nurse (TX LVN)

Astrana Health, Inc.; Monterey Park (CA); Remote; USD 41,000 - 55,000; Full time

Job summary

Astrana Health is seeking a Utilization Review Nurse with a Texas LVN license to support our Health Services Department in reviewing a high volume of outpatient and inpatient cases. The role requires open availability from 8:00 AM to 8:00 PM, Monday through Sunday, with weekend and holiday rotation.

The position is fully remote and will align with PST hours during probation, transitioning to CST after completion. Experience in health plans and knowledge of regulations are preferred.

Qualifications

• Active and unrestricted Texas LVN license.
• Compact license preferred.
• Experience with Microsoft Word, Excel, and Outlook.

Responsibilities

• Complete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment
• Refer cases to Medical Directors as needed/appropriate
• Maintain knowledge of state and federal regulations and accreditation standards
• Comply with internal policies and procedures
• Perform any other job duties as requested

Skills

Health plan experience

Interpersonal skills

Collaboration with leadership

Staff training

Education

LVN license (Texas)

Tools

Microsoft Word

Microsoft Excel

Outlook

Job description

Astrana Health is seeking a Utilization Review Nurse with a Texas LVN license to support our Health Services Department in reviewing a high volume of outpatient and inpatient cases. The role requires open availability from 8:00 AM to 8:00 PM, Monday through Sunday, with weekend and holiday rotation.

The position is fully remote and will align with PST hours during probation, transitioning to CST after completion. Experience in health plans and knowledge of regulations are preferred.