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UM Review Nurse - Texas @ Astrana Health, Inc.

Monterey Park, California, USOnsiteFull-time
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About this role

Astrana Health is looking for a Utilization Review Nurse with a Texas LVN license to assist our Health Services Department in reviewing a high volume of outpatient and inpatient cases. This position will require open availability from 8:00 AM to 8:00 PM Monday through Sunday. The position will rotate weekend and holiday coverage amongst the team. Our Values: Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team Complete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment Refer cases to Medical Directors as needed/appropriate Maintain knowledge of state and federal regulations and accreditation standards Comply with internal policies and procedures Perform any other job duties as requested

Skills

LVN licenseutilization reviewPrior approvals / prior authorizationsaccreditation standards

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