Utilization Review Nurse LVN - PHMI EE Benefits
Company: Prime Healthcare
Location: Lynwood
Posted on: January 12, 2021
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Job Description:
Responsibilities Responsible for the daily coordination and
oversight to the Referral Technicians with regard to referral
distribution and tracking. Assists Director of UR Dept. in
providing oversight and monitoring productivity of UR Coordinators
and Referral Technicians. Provides training to new staff on system
and referral processes. Assists physician offices and vendors with
problem resolution. Knowledgeable in policies, procedures and
practices and keeps updated with regulations applicable to the
department including applicable regulations pertinent to
Self-Funded Plan.#LI-RK1Qualifications Education and Work
ExperienceRequired 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.- High School
Diploma or GEDPreferred qualifications:- Experience and knowledge
of Self-Funded plans, HMO plans, ERISA, and HIPAA guidelines.We are
an Equal Opportunity/ Affirmative Action Employer and do not
discriminate against applicants due to veteran status, disability,
race, gender, gender identity, sexual orientation or other
protected characteristics. If you need special accommodation for
the application process, please contact Human Resources. EEO is the
Law:
https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf
Keywords: Prime Healthcare, Lynwood , Utilization Review Nurse LVN - PHMI EE Benefits, Other , Lynwood, California
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