Utilization Management Nurse, LVN

1yr Contract assignment in Montebello! Utilization Management Nurse, LVN Opportunity!

Schedule: M-F 8/5

Location: Montebello

Term: end date 04/01/2026

Pay $29.52 to $45.76 BOE

Qualifications

1. Current valid License as a Licensed Vocational Nurse

2. Minimum of current 2-3 years of clinical managed care experience

3. Demonstrated ability to work with automated systems, including electronic medical records and MS Office products such as Word, Excel and Outlook.

4. Excellent customer service; ability to be an effective communicator.

5. Knowledge of federal, state, and other applicable standards for clinical practice for assigned area(s) of responsibility.

6. Ability to work collaboratively with diverse individuals and situations, including strong problem-solving and conflict-resolution skills.

The LVN Utilization Management Nurse (UM Nurse) will provide a routine review of authorization requests from all lines of business using respective national/state, health plans, and 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 the medical appropriateness of inpatient and outpatient services following the evaluation of medical guidelines and benefit determination.