Utilization Management License Vocational Nurse (LVN), Full time, Days
PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region.
The fully integrated network is comprised of PIH Health Hospital - Whittier, PIH Health Hospital - Downey and PIH Health Good Samaritan Hospital, 27 outpatient medical locations, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, women's health, urgent care and emergency services.
The organization is recognized by Watson Health as one of the nation's Top Hospitals, and College of Healthcare Information Management Executives (CHIME) as one of the nation's top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology.
PIH Health is certified as a Great Place to Work TM.
For more information, visit PIHHealth.
org or follow us on Facebook, Twitter, or Instagram.
The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) throughout admission and performs concurrent reviews/retrospective reviews according to guidelines.
In addition, the UM LVN delegates to UM RN initial reviews and determines the medical necessity of requests by performing first level reviews.
The UM LVN ensures a process that is efficient for providing care, ensuring timely and appropriate levels of care for the incoming patients.
UM LVN is responsible for preparing cases for Physician Advisor for 2nd level review.
Required Skills Excellent verbal and written communication skills Ability to follow chain of command Highly developed ability to multi-task and maintain focus Proactive, can-do approach and desire to build positive working relationships through collaborative problem-solving Self-motivated and results oriented.
Must be able to demonstrate sound decision making, flexibility and prioritization skills with minimal supervision.
Strong organizational skills Basic computer skills:
Word, Excel, PowerPoint, Outlook.
Able to utilize multiple electronic systems.
Type 50 WPM Ability to apply appropriate UM criteria Required Experience Current licensure as a LVN in the state of California.
A minimum of 2 years of bedside nursing experience in an acute care setting.
A minimum of 2 years of case management experience.
Knowledge of payer requirements.
Preferred:
Certified Case Manager or Accredited Case Manager Beyond the benefits that come with working for the area's leading community healthcare provider - one that also recognizes the need to ensure patient safety and comfort - you'll enjoy an extremely competitive compensation and benefits package.
We are an equal opportunity employer and seek diversity in our workforce.
EOE M/F/D/VAddress11500 Brookshire Ave.
Salary46.
92-77.
43ShiftDaysFLSA StatusNon-ExemptZip Code90241 Recommended Skills Case Management Communication Coordinating Critical Care Decision Making Electronic Systems Estimated Salary: $20 to $28 per hour based on qualifications.
The fully integrated network is comprised of PIH Health Hospital - Whittier, PIH Health Hospital - Downey and PIH Health Good Samaritan Hospital, 27 outpatient medical locations, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, women's health, urgent care and emergency services.
The organization is recognized by Watson Health as one of the nation's Top Hospitals, and College of Healthcare Information Management Executives (CHIME) as one of the nation's top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology.
PIH Health is certified as a Great Place to Work TM.
For more information, visit PIHHealth.
org or follow us on Facebook, Twitter, or Instagram.
The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) throughout admission and performs concurrent reviews/retrospective reviews according to guidelines.
In addition, the UM LVN delegates to UM RN initial reviews and determines the medical necessity of requests by performing first level reviews.
The UM LVN ensures a process that is efficient for providing care, ensuring timely and appropriate levels of care for the incoming patients.
UM LVN is responsible for preparing cases for Physician Advisor for 2nd level review.
Required Skills Excellent verbal and written communication skills Ability to follow chain of command Highly developed ability to multi-task and maintain focus Proactive, can-do approach and desire to build positive working relationships through collaborative problem-solving Self-motivated and results oriented.
Must be able to demonstrate sound decision making, flexibility and prioritization skills with minimal supervision.
Strong organizational skills Basic computer skills:
Word, Excel, PowerPoint, Outlook.
Able to utilize multiple electronic systems.
Type 50 WPM Ability to apply appropriate UM criteria Required Experience Current licensure as a LVN in the state of California.
A minimum of 2 years of bedside nursing experience in an acute care setting.
A minimum of 2 years of case management experience.
Knowledge of payer requirements.
Preferred:
Certified Case Manager or Accredited Case Manager Beyond the benefits that come with working for the area's leading community healthcare provider - one that also recognizes the need to ensure patient safety and comfort - you'll enjoy an extremely competitive compensation and benefits package.
We are an equal opportunity employer and seek diversity in our workforce.
EOE M/F/D/VAddress11500 Brookshire Ave.
Salary46.
92-77.
43ShiftDaysFLSA StatusNon-ExemptZip Code90241 Recommended Skills Case Management Communication Coordinating Critical Care Decision Making Electronic Systems Estimated Salary: $20 to $28 per hour based on qualifications.
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