2 Utilization Review LVN Jobs in Corona, CA

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Utilization Review LVN

KPC Global Medical Centers

Corona, CA | Full Time

$67k-94k (estimate)

1 Month Ago

Utilization Review LVN

KPC GLOBAL MEDICAL CENTERS INC

Corona, CA | Full Time

$72k-96k (estimate)

1 Month Ago

Utilization Review LVN

$67k-94k (estimate)

Full Time 1 Month Ago

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KPC Global Medical Centers is Hiring an Utilization Review LVN Near Corona, CA

Coordinates and reviews all medical records, as assigned to caseload
Actively participates in Case Management and Treatment Team meetings
Serves as on-going educator to all departments
Responsible for reviewing patient charts in order to assess whether the criteria for admission and continuation of treatment is being met; gathering data and responding to request for records from fiscal intermediary; gathering clinical and fiscal information and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting
Able to work independently and use sound judgment.
Knowledge of Federal, State, and intermediary guidelines related to inpatient, acute care hospitalization, as well as lower levels of care for the continuity of treatment.
Coordinates discharge referrals as requested by clinical staff, fiscal intermediary, patients, and families.
Performs other duties as assigned.