All roles

Licensed Vocational Nurse, Utilization Management

Remote · USA Full-time New today

JR8685 Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day. Job Overview The LVN Utilization Management Nurse (UM Nurse) will provide routine review of authorization requests from all lines of business using respective national/state, health plan, and nationally recognized guidelines. Responsible for reviewing proposed hospitalization, home care, and inpatient/outpatient treatment plans for medical necessity and efficiency with coverage guidelines. The UM Nurse determines the medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination. Minimum Requirements

  • Current valid License as a Licensed Vocational Nurse.
  • Minimum of 2 years of managed care experience in Utilization Management/prior authorization required.
  • A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines.

Compensation $31.05 - $38.82 hourly

Compensation

Disclaimer Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives. Benefits & Career Development

  • Medical, Dental and Vision insurance
  • 403(b) Retirement savings plans with employer matching contributions
  • Flexible Spending Accounts
  • Commuter Flexible Spending
  • Career Advancement & Development opportunities
  • Paid Time Off & Holidays
  • Paid CME Days
  • Malpractice insurance and tail coverage
  • Tuition Reimbursement Program
  • Corporate Employee Discounts
  • Employee Referral Bonus Program
  • Pet Care Insurance

Job Advertisement & Application Compliance Statement AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report. Apply tot his job Apply To this Job

Related roles

Supervisor, Utilization Management, FL

Remote · USA Full-time

Supervisor, Utilization Management – Prior Authorization, ND SD MN

Remote · USA Full-time

Remote Clinical Pharmacist – Prior Authorization {168981}

Remote · USA Full-time

[Hiring] Authorization Coordinator @COPE Health Solutions

Remote · USA Full-time

Clinical Review Nurse - Prior Authorization

Remote · USA Full-time

Prior Authorization RN Reviewer

Remote · USA Full-time

Prior Authorization Specialist I

Remote · USA Full-time

Prior Authorization Specialist | Temporary

Remote · USA Full-time

[Hiring] Authorization Specialist @PIEDMONT CANCER INSTITUTE PC

Remote · USA Full-time

Associate Director, Rev Cycle - Prior Authorization

Remote · USA Full-time

Senior Manager, Operations - Identity Customer Experience (Remote Work from Home)

Remote · USA Full-time

Associate Licensed / Pre‑Licensed Mental Health Coach - Remote

Remote · USA Full-time

Experienced Customer Service Representative – Work from Home Opportunity in EST/PST Time Zones

Remote · USA Full-time

Sales Compensation Analyst

Remote · USA Full-time

Experienced Online Data Entry Specialist – Remote Work Opportunity for Teens

Remote · USA Full-time

Experienced Virtual Chat Support Specialist – Remote Customer Service Representative (Full-Time)

Remote · USA Full-time

Experienced Data Entry Specialist – Apple Product Data Management (Remote)

Remote · USA Full-time

MEDICAL RECORDS CODER II

Remote · USA Full-time

Experienced Part-Time Data Entry Remote Associate – Flexible Work Schedule at arenaflex

Remote · USA Full-time

Principal Engineer- Energetics and Propulsion

Remote · USA Full-time