Scanhealthplan
Medical Management Specialist, LVN
Remote, US · Director · Contract
Sponsorship not specified$31k-$45kDetected 30 days ago
ExcelICD-10CommunicationCollaborationProblem SolvingPublic SpeakingMicrosoft Office
About the role
- Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue.
- Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models.
- Conducts pre-service and concurrent review following established guidelines in collaboration with Medical Director as secondary reviewer.
Responsibilities
- Each of us has a responsibility to drive Equality in our communities and workplaces.
Requirements
- Current and active California Licensed Vocational Nurse is required.
- Proficient in Microsoft Word, Excel, Outlook, and PowerPoint, required.
- Strong analytic and problem-solving skills, required.
- Strong verbal and written communication skills, required.
- Ability to multitask and work closely with department RNs.
- Ability to work well in a fast-paced and dynamic environment.
- A background check is required.
Compensation
- An annual employee bonus program
- Eleven paid holidays per year, plus 1 additional floating holiday, plus 1 birthday holiday
- $ 30.77 to $ 44.52 per hour
- We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.
- The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
Benefits
- Certified Professional of Utilization Management (CPUM or CPUR) or other Medical Case Management certification is preferred, or willing to attain such certification with 2 years.
- 3+ years of experience in medical-surgical nursing.
- 3+ years of Utilization Management/Prior Authorization experience in a Managed Care medical group, IPA, or managed care setting.
- Knowledge of (California) managed care industry, Medicare/MediCal required.
- Knowledge of Federal and State healthcare mandates and regulations.
Company info
- Founded in 1977 as the
Equal opportunity
- Employer/Protected Veterans/Individuals with Disabilities
- The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
- However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
- 41 CFR 60-1.35(c)
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This listing is sourced directly from Scanhealthplan's careers page and normalized into a canonical job model.