Top 18 Utilization management lvn Jobs in Los Angeles Ca

Utilization Management Nurse, LVN/LPN (Part Time)
NeueHealth —Los Angeles, CA
- $26.35 - $39.53 an hour
- Part-time
- Remote
- Nursing
- LVN
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
LVN - Quality Assurance/Utilization Review - Business Development - Full Time 8hr Covina, California
Emanate Health —Covina, CA
- $31.03 - $46.54 an hour
- 8 hour shift
- LVN
- Customer service
- Computer literacy
Utilization Management Outpatient Authorization Nurse
Champion Health Plan is a Medicare Advantage Prescription Drug HMO C-SNP serving Medicare beneficiaries with End-Stage Renal Disease. —Long Beach, CA
- From $67,000 a year
- Full-time
- Nursing
- LVN
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Outpatient UM Clinician
MedPOINT Management —Sherman Oaks, CA
- $36 - $48 an hour
- Monday to Friday
- Microsoft Excel
- LVN
- RN License
9d
Home Health Visiting Registered Nurse/Licensed Vocational Nurse/Licensed Practical Nurse
Ambassadore Health Care, Inc. —Long Beach, CA
- $35 - $120 an hour
- Part-time
- Background check
- CPR Certification
- LVN
Quick Apply
4d
Quality Assurance Specialist
First Call Hospice —Los Angeles, CA
- Full-time
- LVN
- RN License
- Computer literacy
Quick Apply
Outpatient UM Coordinator
MedPOINT Management —Sherman Oaks, CA
- $21 - $23 an hour
- Full-time
- Hybrid work
- LVN
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Patient Access & Authorization Specialist
Ocean View Psychiatric Hospital —Long Beach, CA
- $26 - $28 an hour
- 8 hour shift
- Background check
- Current TB test
- LVN
- Health insurance
- Dental insurance
Quick Apply
Utilization Management Nurse, LVN/LPN
NeueHealth —Los Angeles, CA
- $26.35 - $39.53 an hour
- Remote
- Nursing
- LVN
- RN License
- Paid holidays
- Health insurance
Quick Apply
Skilled Nursing MDS Coordinator
Masonic Home: Covina —Covina, CA
- $88,000 - $124,000 a year
- Full-time
- Nursing
- Skilled nursing facility
- Management
- Tuition reimbursement
- Opportunities for advancement
Quick Apply
9d

Other jobs to consider

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Licensed Practical Nurse - LPN -Utilization Management
Cross Country Local —Montebello, CA
Graduated from an accredited LVN school with a current LVN license issued by the State of California, Vocational Nursing. 401(k) with employer match.
$33 - $43 an hour
Quick Apply
Utilization Management Supervisor, Non-Clinical
UCLA Health —Los Angeles, CA
Under the direction of the Utilization Management Assistant Director, the Utilization Management Supervisor (Non-Clinical) oversees the daily operations of non-…
$70,900 - $145,200 a year

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Utilization Management Nurse, LVN/LPN (Part Time)

NeueHealth -
Los Angeles, CA

Quick Apply

Job Details

Part-time
$26.35 - $39.53 an hour

Benefits

Paid holidays
Health insurance
Paid time off
401(k) matching

Qualifications

Collaborate with healthcare professionals
Patient care outcome improvement
Nursing
Patient resource coordination
Certified Managed Care Nurse
Medicare
LVN
Patient advocacy
Quality management
Mid-level
Clinical case management
Transitional care planning in clinical case management
Overseeing care coordination
Pre-authorization review for utilization management
Medicare regulations
InterQual
Utilization management
NCQA standards
Centers for Medicare and Medicaid Services (CMS)
Patient care
Resource utilization in healthcare
Concurrent review in utilization management
Medicaid regulations
Medicaid
Milliman Care Guidelines (MCG Health)
Care coordination
Associate's degree
Associate Degree in Nursing
2 years

Full Job Description

WHO WE ARE

NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.

NeueHealth delivers clinical care to health consumers through our owned clinics – Centrum Health and Premier Medical – as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.

SCOPE OF ROLE

The role of the UM Nurse is to promote quality, cost-effective outcomes for a population by facilitating collaboration and coordination across settings, identifying member needs, planning for care, monitoring the efficacy of interventions, and advocating to ensure member's receive services and resources required to meet desired health and social outcomes. The UM Nurse is responsible for providing patient centered care across the care continuum.

This is a part time position that requires availability to work weekends (Saturday and Sunday).

ROLE RESPONSIBILITIES

Capacity to perform prospective, retrospective, or concurrent medical necessity reviews for an assigned panel of members
Capacity to review cases for medical necessity and apply the appropriate clinical criteria; to include, but not limited to Medicare criteria, Medicaid/Medi-cal criteria, Interqual, Milliman, or Health Plan specific guidelines
Capacity to collaborate with the Medical Director to ensure the integrity of adverse
determination notices based on the quality standards for adverse determinations
Capacity to ensure discharge planning is timely and appropriately communicated to transition of care teams, when applicable.
Capacity to meet or exceed productivity targets set forth
Capacity to serve as a resource to non-clinical team members when applicable
Adheres to the Policies and Procedures set forth by the Quality Management Committee and performs all additional duties as assigned.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

Associate's degree in Nursing, preferred
Minimum 2 years of experience in medical management clinical functions.
Working knowledge of MCG, InterQual, and NCQA standards

LICENSURES AND CERTIFICATIONS

Active California and Unrestricted License as a Licensed Vocational Nurse (LVN)
Certification Managed Care Nursing (CMCN) preferred

WORK ENVIRONMENT

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
Some travel may be required.

For individuals assigned to a location(s) in California, NeueHealth is required by law to include a reasonable estimate of the compensation range for this position. Actual compensation will vary based on the applicant's education, experience, skills, and abilities, as well as internal equity. A reasonable estimate of the range is $26.35-$39.53 Hourly.

Additionally, employees are eligible for health benefits; life and disability benefits, a 401(k) savings plan with match; Paid Time Off, and paid holidays.

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of NeueHealth, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Quick Apply

Refine Your Search

utilization management lvn jobs in los angeles ca

Utilization Management Nurse, LVN/LPN (Part Time)

LVN - Quality Assurance/Utilization Review - Business Development - Full Time 8hr Covina, California

Utilization Management Outpatient Authorization Nurse

Outpatient UM Clinician

Home Health Visiting Registered Nurse/Licensed Vocational Nurse/Licensed Practical Nurse

Quality Assurance Specialist

Outpatient UM Coordinator

Patient Access & Authorization Specialist

Utilization Management Nurse, LVN/LPN

Skilled Nursing MDS Coordinator

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