The Utilization Review LVN nurse will perform documentation review for medical necessity and benefit correlation of requested medical and surgical procedures, services and admissions for HMO, PPO and POS products. The UR LVN nurse will serve as facilitator of communication with clinic, payor and other customers.
Job Title: Licensed Vocational Nurse – Utilization Management
Clinic Location: Pearland Administrative Office
Department: Utilization Management
Job Type: Full Time
Salary Range: $53,123.20 – $65,624 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
Required: Licensed Vocational Nurse, CEU requirement.
Required: Two years utilization review experience at heath plan, ACO, IPA, or provider group OR 3-5 years diverse clinical experience, including acute care or similar care.
Preferred: Computer and Coding experience.
Required: TX LVN license, Valid Driver’s license
Required: Good organization and communication skills.
Required: HMO, PPO and POS insurance knowledge.
Working Environment: Clinic
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.
Why Kelsey-Seybold Clinic?
- Medical, Vision, and Dental
- Tuition Reimbursement
- Company Matching 401K
- Employee Reward and Recognition Program
- Paid time off for vacation, sick, and holidays
- Employee Assistance Program
- Continuing Medical Education allowance