Utilization Review Nurse LVN
Utilization Review Nurse LVN
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$ 66560 - 93600
1 Vacancy
Job Description
Overview
Prime Healthcare is an awardwinning health system headquartered in Ontario California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nations leading health systems with nearly 57000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation a 501(c)(3) notforprofit public charity. Prime Healthcare is actively seeking new members to join our corporate team!
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race color sex sexual orientation gender identity religion national origin age (subject to applicable law) disability military status genetic information or any other basis protected by applicable federal state or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: Notice for California Applicants: 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 SelfFunded Plan.
Qualifications
Required qualifications:
- Possess an active CA Licensed Vocational Nurse (LVN) license.
- Minimum 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 GED
Preferred qualifications:
- Experience and knowledge of SelfFunded plans HMO plans ERISA and HIPAA guidelines.
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. fulltime parttime per diem or temporary. A reasonable compensation estimate for this role which includes estimated wages benefits and other forms of compensation is $66560.00 to $93600.00 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.
Employment Type
Full-Time
