Utilization Review Nurse LVN
Responsibilities
- Responsible for the daily coordination and oversight to the Referral Technicians with regard to referral distribution and tracking.
- Aids the Director of UR Dept. in providing oversight and monitoring productivity of UR Coordinators and Referral Technicians.
- Trains new staff on system and referral processes.
- Aids physician offices and vendors with problem resolution.
Qualifications
- Possess an active CA Licensed Vocational Nurse (LVN) license.
- Minimum (2) two years of experience in acute hospital case management or equivalent.
- Utilization Management experience required.
- Excellent interpersonal relationship skills with exceptional professional work ethics.
- Extensive knowledge of professional and hospital claims.
- Extensive knowledge of coding, billing.
Preferred Qualifications
- Experience and knowledge of Self-Funded plans, HMO plans, ERISA, and HIPAA guidelines.
Pay & Benefits
Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $71,760.00 to $99,590.00 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.