Medical Reviewer, LPN/LVN

Role Overview

• responsible for pre-authorization reviews in accordance with the medical contract and regulations
• medical criteria, utilization review, and quality of care

Requirements

• LPN with valid, current, unrestricted clinical license in the state of operations
• 3 years of clinical experience in physician office, hospital, or surgical setting
• Customer service oriented to assist internal/external customers
• Verbal and written communication skills
• Interpersonal skills and ability to be a team player
• Willingness and ability to travel
• Familiar with PC or database systems
• Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management
• Multi-state license fees will be provided by HCSC
• Incumbents with other clinical licenses are not required to obtain multi-state licenses

Benefits

• health and wellness benefits
• 401(k) savings plan
• pension plan
• paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement
• other incentives