LPN/LVN Case Management Analyst

November 7

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Description

β€’ Collaborates with healthcare providers, members, and partners to optimize benefits. β€’ Conducts medical necessity reviews and compliance. β€’ Supports all Utilization Management activities. β€’ Maintains required licensures and adheres to guidelines. β€’ Achieves operational objectives and departmental goals.

Requirements

β€’ Current Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). β€’ Active unrestricted license in state of residence; compact license a plus. β€’ Minimum 2-3 years clinical experience. β€’ Strong customer orientation and organizational skills. β€’ Knowledge of insurance industry, medical coding (CPT/HCPCS/ICD-10), and claims process a plus. β€’ Knowledge of National Coverage Determinations, Local Coverage Determinations, and MCG criteria are a plus. β€’ Excellent interpersonal and communication skills. β€’ Must be available to work rotating weekends and two holidays a year.

Benefits

β€’ Comprehensive health-related benefits including medical, vision, dental, and well-being programs. β€’ 401(k) with company match. β€’ Company paid life insurance. β€’ Tuition reimbursement. β€’ Minimum of 18 days of paid time off per year. β€’ Paid holidays. β€’ Eligible for annual bonus plan.

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