LVN - Utilization Review - Kelsey Seybold Clinic
About The Position
Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation’s leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Requirements
- Licensed Vocational Nurse (LVN)
- Active Texas LVN license or current multistate/compact LVN license
- 2+ years of utilization review experience at a health plan, ACO, IPA, or provider group
- Ability to maintain CEU requirements
- Proven good organization and communication skills
- Proven HMO, PPO, and POS insurance knowledge
- Valid Driver’s license
Nice To Haves
- Computer and coding experience
Responsibilities
- Perform documentation reviews to assess medical necessity and benefit correlation for requested medical and surgical procedures, services, and admissions for HMO, PPO, and POS products
- Serve as a facilitator of communication with the clinic, payor, and other customers
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
