LVN - Quality Assurance/Utilization Review - Business Development - Full Time 8hr
Emanate Health(1 year ago)
About this role
The Utilization Review Nurse at Emanate Health evaluates medical records to determine medical necessity for urgent and standard reviews, documenting decisions according to clinical guidelines and protocol sets. The role supports review of medical claims and utilization practices, applying clinical judgment and referring cases to Medical Directors as needed.
Required Skills
- Medical Records
- Medical Necessity
- Clinical Acumen
- Clinical Guidelines
- Documentation
- Medical Claims
- Utilization Review
- Care Level
- Clinical Judgment
- Computer Proficiency
+1 more
Qualifications
- California LVN License
About Emanate Health
emanatehealth.orgWelcome to Emanate Health, providing quality health care from a compassionate staff to the East San Gabriel Valley.
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