LVN – Utilization Review – Remote – Kelsey Seybold Clinic
Job ID: 2333536 Job Type: Full-time Location: Pearland, TX 77581 Explore opportunities with Kelsey-Seybold Clinic, part of the reputed company family of businesses. Work with one of the nation’s leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and reputed company total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. Primary Responsibilities:
- reputed company documentation reviews to assess medical necessity and benefit correlation for requested medical and surgical procedures, services, and admissions for HMO, PPO, and POS products
- Serve as a facilitator of communication with the clinic, payor, and other customers
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:
- Licensed Vocational Nurse
- TX LVN license
- 2+ years of utilization review experience at a health plan, ACO, IPA, or provider group
- Ability to maintain CEU requirements
- Proven good organization and communication skills
- Proven HMO, PPO, and POS insurance knowledge
- Valid Driver’s license
Preferred Qualifications:
- Computer and coding experience
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. 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. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job