Medical Reviewer LPN
This position is responsible for pre-authorization reviews in accordance with the medical contract and regulations, medical criteria, utilization review, and quality of care.
• LPN with valid, current, unrestricted clinical license in the state of operations.
• 3 years of clinical experience in physician office, hospital, or surgical setting.
• Customer service oriented to assist internal/external customers.
• Verbal and written communication skills.
• Interpersonal skills and ability to be a team player.
• Willingness and ability to travel.
• Familiar with PC or database systems.
• Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management. Multi-state license fees will be provided by HCSC. Incumbents with other clinical licenses are not required to obtain multi-state licenses.
PREFERRED JOB REQUIREMENTS:
• Utilization review or utilization management experience
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Requirements: Expertise Nursing Job Type Full-Time Regular Location IL - Chicago, TX - Richardson
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