Employer Industry: Healthcare Services

Why Consider this Job Opportunity:
- Flexibility to work remotely from anywhere within the U.S.
- Clear direction and development opportunities for career growth
- Performance recognition and rewards
- Challenging work environment
- Development opportunities for other roles within the organization
- Competitive pay based on factors such as education, work experience, and certifications

What to Expect (Job Responsibilities):
- Prepare and submit pre-audit documentation as outlined on Health Plan audit tools
- Communicate with Health Plan auditors regarding audit documents and processes
- Collaborate across the organization to gather necessary documentation for audits
- Facilitate compliance audit reviews to ensure regulatory requirements adherence
- Participate in performance improvement activities
- Conduct internal audits of the utilization management process

What is Required (Qualifications):
- Graduation from an accredited Licensed Vocational/Practical Nurse program
- Current LVN/LPN license
- 2+ years of clinical experience as an LVN/LPN
- 1+ years of utilization management experience, especially Prior Authorization

How to Stand Out (Preferred Qualifications):
- 3+ years of experience as an LVN/LPN
- 2+ years of care management, utilization review, or discharge planning experience
- Experience in an HMO or Managed Care setting
- Base knowledge of requirements for Medicare, Medi-Cal, and Commercial lines of business

#HealthcareServices #RemoteWork #CareerGrowth #CompetitivePay #PerformanceRecognition

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