AltaMed Health Services
Montebello, CA, USA
AltaMed Health Services We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law. Nurse, (LVN) Utilization Mngmt US-CA-Montebello Job ID: 2023-17171 Type: Regular Full-Time # of Openings: 1 Montebello MSO 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, 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 medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination. Responsibilities...