California Licensed Utilization Management Nurse in Blackman, MI
Job Description
A company is looking for a Utilization Management Nurse - LVN (Work from Home).
Key Responsibilities
Perform medical necessity reviews for assigned members
Collaborate with the Medical Director on adverse determination notices
Ensure timely discharge planning and communication with care teams
Required Qualifications, Training, and Education
Associate's degree in Nursing, preferred
Minimum 2 years of experience in medical management clinical functions
Working knowledge of MCG, InterQual, and NCQA standards
Active and Unrestricted License as a Licensed Vocational Nurse (LVN) in California
Certification in Managed Care Nursing (CMCN) preferred
Key Responsibilities
Perform medical necessity reviews for assigned members
Collaborate with the Medical Director on adverse determination notices
Ensure timely discharge planning and communication with care teams
Required Qualifications, Training, and Education
Associate's degree in Nursing, preferred
Minimum 2 years of experience in medical management clinical functions
Working knowledge of MCG, InterQual, and NCQA standards
Active and Unrestricted License as a Licensed Vocational Nurse (LVN) in California
Certification in Managed Care Nursing (CMCN) preferred
Job Details
Employment Type
Full-time
Required License
LVN (Licensed Volunteer Nurse)
Years of Experience
Intermediate
Work Setting
Telehealth
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