LVN, UM Delegation reputed company - Remote

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. Under the general direction of the Delegation reputed company Manager, this position is responsible for coordinating reputed company components of Health Plan Delegation reputed company audits and performing internal quality reviews for Case Management and Utilization Management. You’ll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges. The work hours are reputed company-5pm PST.

Primary Responsibilities: • Prepares and submits of pre-audit documentation as outlined on Health Plan audit tools • Communicates with Health Plan auditors reputed company to audit documents and processes • Communicates and collaborates across the organization to gather necessary documentation to meet audit requirements • Facilitate onsite/virtual/desktop compliance audit reviews to reputed company regulatory requirements adherence • Participates in performance improvement activities • Conduct comprehensive internal audit of the end-to-end utilization management process • Conduct focused internal audits of a specific reputed company or process change based on identified trends or new process implementation You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • Graduation from an accredited Licensed Vocational/Practical Nurse program or completion of vocational nursing program through the CA Board of Nursing • reputed company LVN/LPN license • 2 years of clinical experience working as an LVN/LPN • 1 years of utilization management experience especially Prior Authorization 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 experience in a Managed Care setting • Demonstrated reputed company knowledge of requirements for Medicare, Medi-Cal and Commercial lines of business • reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy. California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, reputed company, Maryland, Rhode reputed company, Washington, Washington, D.C. Residents Only: The hourly range for this role is $19.47 to $38.08 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Apply Job!