Position Type: PRN (Per Diem), with opportunities to transition to Part-Time or Full-Time based on performance**
**Company: bServed**
**Job Summary:**
bServed is seeking a dedicated and detail-oriented Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) for a Utilization Management position. This role involves evaluating medical necessity, appropriateness, and efficiency of healthcare services for our patients. This is a remote position, allowing you to work from home. Candidates must have a California nursing license, but we welcome applicants from any state and will cover all costs associated with obtaining a California license.
**Key Responsibilities:**
- Conduct initial, concurrent, and retrospective reviews to determine the medical necessity of inpatient and outpatient services.
- Review medical records to identify the member’s initial discharge needs and complete relevant documentation.
- Collaborate with healthcare providers to facilitate discharge planning and ensure a safe transition of care.
- Perform psychosocial assessments and develop comprehensive care plans for patients.
- Participate in daily discharge planning and document all interactions and interventions in Access Express (AE).
- Communicate effectively with patients, families, and healthcare team members to provide education and support regarding changes in condition and self-management.
- Ensure compliance with Medicare, Medicaid, and other regulatory guidelines during the review process.
- Utilize clinical guidelines and criteria to evaluate medical necessity and appropriateness of care.
- Maintain accurate and timely documentation in electronic medical records.
**Qualifications:**
- Active LVN/LPN license in California or willingness to obtain one (we will cover the cost).
- Minimum of 1 year of clinical nursing experience, preferably in utilization management or case management.
- Strong understanding of discharge planning, psychosocial assessment, and utilization management processes.
- Experience with MCG (Milliman Criteria Guidelines).
- Excellent communication and interpersonal skills.
- Proficient in using electronic medical records and other healthcare documentation systems.
- Ability to work independently and manage time effectively in a remote work environment.
- Strong analytical and critical thinking skills.
**Benefits:**
- Competitive pay offered.
- Flexible PRN position with the potential to transition to part-time or full-time based on performance.
- Opportunity to work from home, providing a better work-life balance.
- Coverage of all costs associated with obtaining a California nursing license for non-California licensed applicants.
**Application Process:**
To apply, please submit your resume and cover letter outlining your qualifications and experience. We look forward to welcoming a dedicated and compassionate nurse to our team!
**Company Overview:**
bServed is committed to providing high-quality healthcare services and ensuring the best outcomes for our patients. We value our employees and offer opportunities for professional growth and development. Join us in making a difference in the lives of our patients while enjoying the flexibility and benefits of working remotely.
Job Types: Full-time, Part-time, PRN
Pay: From $20.00 per hour
Standard shift:
Weekly schedule:
License/Certification:
- LVN (Required)
- LPN (Required)
Work Location: Remote