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California Licensed Nurse
A company is looking for a Nurse. Key Responsibilities: Perform medical necessity reviews for an assigned panel of members Review cases for medical necessity and apply appropriate clinical criteria Collaborate with the Medical Director on adverse determination notices and ensure timely discharge planning Minimum Qualifications: Minimum 2 years of experience in medical management clinical functions Active and Unrestricted California LVN (Licensed Vocational Nurse) Working knowledge of MCG, InterQual, and NCQA standards
A company is looking for a Nurse.
Key Responsibilities:
Perform medical necessity reviews for an assigned panel of members
Review cases for medical necessity and apply appropriate clinical criteria
Collaborate with the Medical Director on adverse determination notices and ensure timely discharge planning
Minimum Qualifications:
Minimum 2 years of experience in medical management clinical functions
Active and Unrestricted California LVN (Licensed Vocational Nurse)
Working knowledge of MCG, InterQual, and NCQA standards