Large managed care company is looking for a UM LPN/LVN for a contract to hire position.

Work Location:3900 Fifth Avenue, San Diego, CA  92103. Hybrid work model: 2-3 days in office (underground parking paid by company)

Pay: $33.00

Contract Dates: CONTRACT TO HIRE

Hours: Monday – Friday 8:00 am to 5:00 pm

RESPONSIBILITIES

• Performs reviews of outpatient services.
• Determines medical appropriateness of pre-cert inpatient and outpatient services following evaluation of medical guidelines and benefit determination.
• Responds to urgent, routine or standard requests.
• Uses existing procedures and facts to solve routine problems or conduct routine analyses.
• Discuss patient care specifics with peers or providers involved in overall patient care and benefits.
• Leverage appropriate clinical terminology when communicating with physicians and other medical professionals
• Provide summary clinical and ancillary information to plan Medical Director for review and decision-making
• Communicate clinical findings and present rationale for decisions to medical professionals and members at the appropriate level for understanding.

QUALIFICATIONS

• Associate's Degree
• California licensed LPN/LVN
• Basic knowledge of theories, practices and procedures in a function or skill