Alura Workforce Solutions
UM Nurse, LVN 25-00418
Alura Workforce Solutions, Rancho Cucamonga, California, United States, 91739
Overview
UM Nurse, LVN. Position Type: Temporary. Schedule: M-F, 8:00 am - 5:00 pm; Remote. Assignment Length: Approximately 6-Months, possibly longer. Description
Under the general direction of the Utilization Management Clinical Manager and Supervisor, and within the LVN scope of practice, the incumbent is responsible for working directly with Providers, contracted entities, and vendors to ensure coordinated, continuous cost-effective quality healthcare for IEHP Members. Responsibilities
Collaborate with Providers, contracted entities, and vendors to coordinate care for IEHP Members. Support utilization management processes to ensure cost-effective, quality healthcare delivery. Requirements
Two (2) or more years of utilization management experience in a health care delivery setting Experience in an HMO or experience in a Managed Care setting preferred High School Diploma or GED required Possession of an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians required Key Qualifications
Knowledge of Title 22, Title 10, DMHC, DHCS, and CMS regulatory requirements. ICD-9/10 and CPT coding Knowledge of capitated managed care environment helpful MediCal, Medicare and other state/federal Program & Regulations Proficiency in Excel preferred Microcomputer skills, proficiency in Windows applications preferred Excellent communication and interpersonal skills Strong organizational skills Professional demeanor Additional Details
Seniority level: Mid-Senior level Employment type: Temporary Job function: Other Industries: IT Services and IT Consulting
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UM Nurse, LVN. Position Type: Temporary. Schedule: M-F, 8:00 am - 5:00 pm; Remote. Assignment Length: Approximately 6-Months, possibly longer. Description
Under the general direction of the Utilization Management Clinical Manager and Supervisor, and within the LVN scope of practice, the incumbent is responsible for working directly with Providers, contracted entities, and vendors to ensure coordinated, continuous cost-effective quality healthcare for IEHP Members. Responsibilities
Collaborate with Providers, contracted entities, and vendors to coordinate care for IEHP Members. Support utilization management processes to ensure cost-effective, quality healthcare delivery. Requirements
Two (2) or more years of utilization management experience in a health care delivery setting Experience in an HMO or experience in a Managed Care setting preferred High School Diploma or GED required Possession of an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians required Key Qualifications
Knowledge of Title 22, Title 10, DMHC, DHCS, and CMS regulatory requirements. ICD-9/10 and CPT coding Knowledge of capitated managed care environment helpful MediCal, Medicare and other state/federal Program & Regulations Proficiency in Excel preferred Microcomputer skills, proficiency in Windows applications preferred Excellent communication and interpersonal skills Strong organizational skills Professional demeanor Additional Details
Seniority level: Mid-Senior level Employment type: Temporary Job function: Other Industries: IT Services and IT Consulting
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