Clinical LVN
NAMM North America Medical Management - San Diego, CA

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SNF Case management at multiple facilities (telephonic with some possible on site)

Transplant reviews

Denial letters

outpatient referral reviews

EIODs

Responsibilities:

Manage SNF patients in various facilities

Review requests for transplants, notify healthplans and direct to contracted facilities

Clerical input of clinical data for denial letters

Review outpatient referrals for necessity, contracted vendors, benefits

Manage EIOD process per instructions from UM Supervisor

Qualifications:

Licensed LVN with Case Management experience

computer skills - data entry

Understanding of referral processes/denials, HMO requirement, Plan benefits

IND23

*CB

MW

NAMM North America Medical Management - 13 months ago - save job - block
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