Remote Case Management Analyst | LPN/LVN | TN, IL, TX, OK, NM or MT
Position: Remote Case Management Analyst (LPN/LVN)
Duration: 6 + months (Possible Extension)
Schedule: Monday - Friday, 8-5pm CST or EST
Description:
• LPN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.
• Workers will be remote but should be located in TN, IL, TX, OK, NM or MT.
This position is responsible for pre-authorization reviews in accordance with the medical contract and regulations, medical criteria, utilization review, and quality of care.
Job Requirements:
• LPN with valid, current, unrestricted clinical license in the state of operations.
• Clinical experience in Home Health and DME
• Utilization review or utilization management experience
• Clinic Review for medical necessity based on specific needs of the patient and evidence supporting it and appropriateness of services.
• Clinical Reviewer with relevant expertise and Medicare UM experiences responsible for making determinations utilizing the correct criteria and consider the clinical information provided.
• Customer service oriented to assist internal/external customers.
• Verbal and written communication skills.
• Interpersonal skills and ability to be a team player.
• Familiar with PC or database systems.
• Incumbents with nursing licenses in positions/departments requiring multi-state licenses or compact licensure within your residential state.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. Maintain complete confidentiality of company business.
• Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
• Maintain production requirements based on established department business needs.
EEO: “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
Apply Now
Apply Now
Duration: 6 + months (Possible Extension)
Schedule: Monday - Friday, 8-5pm CST or EST
Description:
• LPN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.
• Workers will be remote but should be located in TN, IL, TX, OK, NM or MT.
This position is responsible for pre-authorization reviews in accordance with the medical contract and regulations, medical criteria, utilization review, and quality of care.
Job Requirements:
• LPN with valid, current, unrestricted clinical license in the state of operations.
• Clinical experience in Home Health and DME
• Utilization review or utilization management experience
• Clinic Review for medical necessity based on specific needs of the patient and evidence supporting it and appropriateness of services.
• Clinical Reviewer with relevant expertise and Medicare UM experiences responsible for making determinations utilizing the correct criteria and consider the clinical information provided.
• Customer service oriented to assist internal/external customers.
• Verbal and written communication skills.
• Interpersonal skills and ability to be a team player.
• Familiar with PC or database systems.
• Incumbents with nursing licenses in positions/departments requiring multi-state licenses or compact licensure within your residential state.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. Maintain complete confidentiality of company business.
• Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
• Maintain production requirements based on established department business needs.
EEO: “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
Apply Now
Apply Now