Utilization Management LPN at The Judge Group Inc. in Mendota, Minnesota

Posted in Other about 12 hours ago.





Job Description:

Location: Mendota, MN

Salary: $28.00 USD Hourly - $30.00 USD Hourly

Description: Our client is currently seeking a Utilization Management Licensed Practical Nurse to join our team!



Position Title: Delegation Oversight Nurse



Position Type: Contract to Hire



Location: Remote/Telecommute (Must work PST hours; can live anywhere in the USA)



Hours: Monday-Friday, 8am-5pm PST



Rate: $28.00 - $30.00/hour



Primary Responsibilities:





  • Collaborate with the Manager of Delegation Oversight to manage delegation oversight and regulatory audits.

  • Utilize knowledge of clinical services regulatory and delegation requirements to represent Optum Clinical Services during delegation oversight audits.

  • Act as a liaison between Health Plan delegated entities and Clinical Services Operational teams (Utilization Management and Case Management).

  • Serve as a liaison between Delegation Oversight and cross-functional areas/departments across the organization.

  • Use, protect, and disclose Optum patients' protected health information (PHI) in accordance with HIPAA standards.




Required Qualifications:





  • Graduation from an accredited Licensed Vocational/Practical Nurse program.

  • Current LVN/LPN license in State of Residence.

  • 2+ years of experience in care management, utilization review (prior authorization), or discharge planning.




Preferred Qualifications:





  • Experience in an HMO or Managed Care setting.

  • Basic knowledge of requirements for Medicare, Medi-Cal, and Commercial lines of business.



Send us your resume for immediate consideration: mgautreau@judge.com






Contact: mgautreau@judge.com


This job and many more are available through The Judge Group. Find us on the web at www.judge.com
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