Medical Case Manager (LVN)
The Judge Group Inc.

Orange, California

This job has expired.


Location: Orange, CA
Description: The Judge Group is currently seeking a Nurse Case Manager in Orange, CA!

This job will have the following responsibilities:

  • Verify and process specialty referrals, diagnostic testing, home health care services, outpatient procedures, and DME equipment and supplies via phone or fax using established clinical protocols to determine medical necessity.
  • Screen requests for the Medical director to review by gathering pertinent medical information prior to submission to the Medical Director; follows up with requester and communicates Medical Director's decision.
  • Reviews HCPCS, ICD-10, and CPT-4 codes for accuracy.
  • In contact with Health Networks and/or Customer Service regarding health network enrollments.
Qualifications & Requirements:
  • High School Diploma required, Associates or Bachelor's Degree in related field preferred.
  • Active RN or LVN license to practice in the State of California required.
  • 1+ years of Utilization Management / Prior Authorization Review experience required.
  • Ability to communicate clearly both verbally and in written formats.
  • Ability to utilize and access computer programs such as Microsoft Office and job specific applications

If you would be interested to apply, please send your most updated resume to Lindy at lburks@judge.com!

Lindy Burks

Recruiter Associate

Phone: 720-463-3584

Contact: lburks@judge.com

This job and many more are available through The Judge Group. Find us on the web at www.judge.com


This job has expired.

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