UM Case Manager- LVN or RN

Orange, CA 92868

Post Date: 05/07/2018 Job ID: 42629 Profession: LVN Case Manager

Want to work for one of the highest rated best companies to work for in Orange County? Have a passion for healthcare and looking for a large organization to build your career? You have found the perfect match!! Large multi-facility with multi-specialty medical group has an immediate need for a Case Manager. Company provides a fun team environment with employee activities, rewards, and community involvement opportunities. Position based out of corporate office in Central OC.

Job Activities:

Reviewing cases for clinical necessity

Reviewing cases to insure all guidelines were met for insurance companies

Confirming proper eligibility and authorizations were received

Reviewing denials and correcting language for appeals

Reviewing referrals received

Researching cases and steps taken

Generating reports on various cases

Suggesting corrections for future issues and cases

Communicating with Physicians as needed

Abstracting and reviewing charts

Insuring timelines were met for authorization processes

Assisting with other projects as needed

Requirements:

Current CA RN or LVN license

HS Diploma or GED


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