-
Utilization Review LVN
2 weeks ago
Common Spirit Bakersfield, CA, United StatesOverview · * This position is remote with a clear and current CA LVN license. · The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structure. We of ...
-
Utilization Review LVN
2 weeks ago
Dignity Health Bakersfield, CA, United States**Overview** · *****This position is remote with a clear and current CA LVN license.** · The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structu ...
-
Lead Nurse
2 weeks ago
Pinnacle Treatment Centers Bakersfield, United States**Lead Nurse** · **We offer competitive salary, full benefits package, Paid Time Off, and opportunities for professional growth.** · Aegis / Pinnacle Treatment Centers is a growing leader in addiction treatment services. We provide care across the nation touching the lives of mor ...
-
Lvn I
3 weeks ago
Kaiser Permanente Bakersfield, United States**Job Summary**: · Licensed Vocational Nurses are licensed health professionals who perform patient care, technical and supportive services under general supervision in a medical office or clinical setting. The LVN supports the philosophy and complies with the protocols, policies ...
-
lvn i
2 days ago
Kaiser Bakersfield, United States Full timeJob Summary: · Licensed Vocational Nurses are licensed health professionals who perform patient care, technical and supportive services under general supervision in a medical office or clinical setting. The LVN supports the philosophy and complies with the protocols, policies an ...
-
Lvn Iv Therapy Specialist
1 week ago
California Retina Consultants Bakersfield, United States**LVN - IV Therapy Specialist** · The IV Therapy Specialist (Licensed Vocational Nurse) is responsible for administering fluorescein intravenously for angiography procedures at our Bakersfield, Oxnard, and Santa Barbara locations. In addition to this specialized duty, the IV Ther ...
-
Lvn - Central
1 hour ago
Clinica Sierra Vista Bakersfield, United States**Clinica Sierra Vista is excited to be one of the largest Federally Qualified Health Centers in the Nation** We're honored to serve the men and women of the fields. We also offer care and support to the inner city, the rural and isolated, those of low, moderate, and fixed income ...
-
Registered Nurse
6 days ago
Innovative Integrated Health Inc. Bakersfield, United States**WHO WE ARE**: · Are you interested in working for an organization whose mission it is to enable frail, underserved, and multicultural senior communities to live independently at home and in their communities, for as long as possible? · Bakersfield Program of All-Inclusive Care ...
-
MDS Coordinator RN
3 weeks ago
Human Good Bakersfield, United StatesUnder limited supervision of Health Services Administrator, this position develops, completes, and transmits resident assessments (MDS - Minimum Data Set) in accordance with current Federal and State standards. The incumbent applies comprehensive knowledge of MDS processes, perfo ...
-
LVN Full-Time
15 hours ago
Kern River Transitional Care Bakersfield, United States Full timeJob description · LVN Direct the day-to-day functions of the nursing assistants in accordance with current rules, regulations, and guidelines that govern the long-term care facility. · Ensure that all nursing personnel assigned to you comply with the written policies and proce ...
-
lvn hilltop
2 weeks ago
Integrated Practice Management LLC Bakersfield, United StatesJob Description · Job DescriptionDescription:About this role · The Licensed Vocational Nurse (LVN) is responsible for assisting and data collection in the delivery of patient care through the nursing process of assessment, planning, implementation and evaluation in the healing Se ...
-
LVN Case Management
1 day ago
Heritage Provider Network Bakersfield, United StatesJob Description · Under the direction of the Supervisor, this position is responsible to assess, diagnose, plan, implement, and evaluate the patient to facilitate and coordinate the patient's plan of care with the provider. The Case Manager will help determine when patients are ...
-
LVN - Central
2 weeks ago
Clinica Sierra Vista Bakersfield, United StatesJob Description · Job DescriptionClinica Sierra Vista is excited to be one of the largest Federally Qualified Health Centers in the Nation We're honored to serve the men and women of the fields. We also offer care and support to the inner city, the rural and isolated, those of lo ...
-
Medical Health LVN
1 week ago
Kaiser Permanente Bakersfield, CA, United StatesJob Summary: · Licensed Vocational Nurses are licensed health professionals who perform patient care, technical and supportive services under general supervision in a medical office or clinical setting. The LVN supports the philosophy and complies with the protocols, policies an ...
-
LVN/LPT/RN- Full-Time
4 weeks ago
Crestwood Behavioral Health Bakersfield, United States Full timeJob Description · Job DescriptionAre you looking for a meaningful role in behavioral health and have the desire to work with an organization that puts people first? If you have a passion for helping others along their recovery journey, then we invite you to join our Crestwood fam ...
-
LVN/LPT/RN- Full-Time
4 weeks ago
Crestwood Behavioral Health Bakersfield, United States Full timeJob Description · Job DescriptionAre you looking for a meaningful role in behavioral health and have the desire to work with an organization that puts people first? If you have a passion for helping others along their recovery journey, then we invite you to join our Crestwood fam ...
-
Home Health Patient Coordinator
2 weeks ago
Get Well Home Health Inc Bakersfield, United StatesJob Description · Job DescriptionWe are a Home Health Agency in Bakersfield, CA that is looking for a self motivated, compassionate RN or LVN Home Health Patient Coordinator (Non-licensed clinicians/medical staff are encouraged to apply so long as they have previous home health e ...
-
lvn staff nurse
3 weeks ago
Rehabilitation Center of Bakersfield Bakersfield, CA , USA, United StatesRehabilitation Center of Bakersfield - · A licensed professional nurse under the supervision of a Registered Nurse who provides nursing care and services to residents in a long-term care setting. · Qualifications: · • Graduate of an accredited school of nursing or an approved ...
-
Lead Nurse
1 week ago
Aegis Treatment Centers Bakersfield, United StatesJob Description · Job DescriptionLead Nurse · Full-Time · We offer competitive salary, full benefits package, Paid Time Off, and opportunities for professional growth. · Aegis / Pinnacle Treatment Centers is a growing leader in addiction treatment services. We provide care across ...
-
Performance Improvement Coordinator
22 hours ago
Kern Medical Bakersfield, United States Full timePOSITION: Performance Improvement Coordinator (RN) - Full-time - Quality Performance Improvement · Kern Medical strives to recruit the highest quality candidates, resulting in a high performance workforce that consistently delivers quality patient care. · Career Opportunities w ...
Utilization Review LVN - Bakersfield, CA, United States - CommonSpirit Health
Description
***This position is remote with a clear and current CA LVN license.
The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.
Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
***This position is remote with a clear and current CA LVN license.
Position Summary:
The Utilization Review LVN uses clinical judgement in providing utilization management services. The focus is to provide high quality cost-effective care which will enable patients to achieve maximum medical improvement while receiving care deemed medically necessary.
Responsibilities may include:
- Conducts pre-authorization referral reviews following workflow as written document criteria to make determination or recommendation and process the referral in a timely manner.
- Researches correct information and/or uses pend letter appropriately when facts are needed to reach determination.
- Preps case thoroughly concisely and clearly for physician review. Researches EMR criteria medical policy and past history of member to detail case cleanly for MD.
- Watches for follow up and processes denials as indicated.
- Performs audits of medical records as requested or appropriate.
- Recommends and coordinates interventions to facilitate high quality cost-effective care monitoring treatment progress and outcomes of patients.
- Performs other duties as assigned.
Minimum Qualifications:
- Minimum 3-5 years of healthcare experience with general knowledge of Utilization Management and Managed Care.
- Graduate of accredited school of nursing; Clear and current CA Licensed Vocational Nurse (LVN) license.
- Must be able to communicate clearly and concisely with all levels of individuals sometimes in stressful situations. Demonstrated ability to independently evaluate and interpret clinical information and care planning. Ability to perform job functions independently and with minimal supervision.
- Effective oral written and listening communication skills necessary for constant interaction with patients families physicians and other members of the health team.
- Able to stay organized and flexible in a work environment with multiple assignments and changing priorities
- Word processing keyboarding and non-scripted documentation skills. Able to operate PC-based software program.
Preferred Qualifications:
- Preferred 5-7 years of experience in combination of utilization management prior authorization or acute/sub-acute care experience.
- Understanding of assessment tools such as InterQual MCG and DRGs preferred.
- Direct experience working with Managed Care and Medicare/Medicaid Regulations preferred.
- Direct experience working with physicians preferred.
