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Below are the detail of job "LVN - Authorization, Case Manager - Health Plan ":

JOB #   18A*
JOB TITLE   LVN - Authorization, Case Manager - Health Plan
JOB DESCRIPTION  

 Description

    • Medical Service Organization (MSO. Medical Group, IPA)
    • Telephonic Case Manager
    • Prior Authorization (Referral) and/or Ambulatory Case Manager and/or Concurrent Review (Placed in one of the three depending on experience)
QUALIFICATIONS  

About the Job:

    1. Fast Paced Office Environment.
    2. Monday - Friday; 40 Hours a Week
    3. Home Health or SNF Case Manager with 5+ years experience please apply
    4. Medical Office Administrator, Manager or Coordinator with 3+ years experience please apply


       

LOCATION   Encino, CA
JOB TYPE   Temporary
REQUIREMENTS  
  • Knowledgeable of:

    • Guidelines and regulations relevant to case management and/or utilization management.

    • ICD-9 and CPT coding, requirements for prior approval.

    • Effective charting practices and guidelines.

    • Principles and practices of health care, health care systems, and medical administration.

    • Available community resources.
    • Available medical treatments and resources.
    • Methods to identify patient needs such as discharge planning, Home Health, DME and SNF’s.
  • ADDITIONAL REQUIREMENTS   N/A
    LICENSES/CERTIFICATIONS   Valid CA Nursing License

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