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ArchWell Health

Kansas City, Missouri

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Optum

Boulder, Colorado

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Centura Health / CommonSpirit Health

Canon City, Colorado

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Penn State Health

Enola, Pennsylvania

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WMCHealth

Poughkeepsie, New York

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MultiCare Health System

Auburn, Washington

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AdventHealth

Celebration, Florida

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Vanderbilt Health

Nashville, Tennessee

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Optum

Providence, Rhode Island

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Centura Health / CommonSpirit Health

Lakewood, Colorado

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CHRISTUS Health

Corpus Christi, Texas

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BJC HealthCare

Saint Peters, Missouri

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Kindred Hospitals

Indianapolis, Indiana

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Natividad

Salinas, California

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AdventHealth

Shawnee Mission, Kansas

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MultiCare Health System

Tacoma, Washington

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Optum

Deltona, Florida

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MultiCare Health System

Tacoma, Washington

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Utilization Mgmt LVN
JOB SUMMARY: Manages Requests for Outside Services. Applies Screening Criteria for Harris Health eligible patients. Secures authorization for third party payers by providing pertinent clinical documentation according to payer guidelines. Communicates with clinic staff regarding insurance denials and impending insurance authorization expirations. Facilitates peer to peer review between the clinical staff and the payer for denied cases. Enters authorization information into EPIC Telephone Encounters. Schedule patients for outsourced procedures. Follows up with test results and ensure placement in EPIC for physician retrieval. Strong written and verbal skills are necessary in order to communicate with clinical staff and payers. MINIMUM QUALIFICATIONS: Edu


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