Licensed Vocational Nurse (LVN) - Preservice Review Nurse (Remote)

Job Summary:

Join our team as a Licensed Vocational Nurse (LVN) - Preservice Review Nurse, working remotely, and be part of shaping the future of healthcare. We are seeking a highly skilled LVN to join our team, focusing on prior authorization reviews, ensuring timely and accurate assessments that meet contractual and regulatory requirements.

Key Responsibilities:

• Screen and review referrals and authorizations for medical necessity and appropriateness of service and care, collaborating with Medical Directors as needed.
• Coordinate healthcare services with physicians, facilities, providers, and community resources.
• Conduct prospective reviews to determine appropriateness of denial, alternative treatment, and draft denial language.
• Manage out-of-network and out-of-area cases with members, health plans, and Case Management teams.
• Develop and maintain effective relationships with physicians, office staff, and other stakeholders.
• Demonstrate understanding of cost consequences of care management decisions and maintain effective communication with health plans, physicians, hospitals, and patients.

Requirements:

• Graduation from an accredited Licensed Vocational Nurse program.
• Active, unrestricted LVN license in California.
• 2+ years of clinical experience in an acute or ambulatory patient care setting, including 1 year in a managed care environment.
• Ability to work 8-5PM PST.

Preferred Qualifications:

• 3+ years of experience working as an LVN/LPN.
• 2+ years of care management, utilization review, or discharge planning experience.
• Experience in an HMO or Managed Care setting.

What We Offer:

• Competitive salary ($19.47 - $38.08 per hour for California residents).
• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution.

About Us:

At UnitedHealth Group, we are committed to helping people live healthier lives and making the health system work better for everyone. We value diversity, equity, and inclusion, and strive to create a workplace that is welcoming and inclusive for all employees.

How to Apply:

If you are a motivated and compassionate LVN looking to make a difference in healthcare, we encourage you to apply for this exciting opportunity.