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Utilization Review Nurse LVN
full-timeOntario$68k - $90k

Summary

Location

Ontario

Salary

$68k - $90k

Type

full-time

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About this role

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

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Responsibilities

Responsible for the daily coordination and oversight to the Referral Technicians with regard to referral distribution and tracking. Assists Director of UR Dept. in providing oversight and monitoring productivity of UR Coordinators and Referral Technicians. Provides training to new staff on system and referral processes. Assists physician offices and vendors with problem resolution. Knowledgeable in policies, procedures and practices and keeps updated with regulations applicable to the department including applicable regulations pertinent to Self-Funded Plan.

Qualifications

Required qualifications:

  • Possess an active CA Licensed Vocational Nurse (LVN) license.
  • Minimum (2) two years of experience in acute hospital case management or equivalent.
  • Utilization Management experience required.
  • Excellent interpersonal relationship skills with exceptional professional work ethics.
  • Extensive knowledge of professional and hospital claims.
  • Extensive knowledge of coding, billing.
  • High School Diploma or GED
  • Preferred qualifications:

  • Experience and knowledge of Self-Funded plans, HMO plans, ERISA, and HIPAA guidelines.
  •  

    Pay Transparency

    Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options.  Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary.  A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $68,640.00 to $90,001.60 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

    Employment Status

    Full Time

    Shift

    Days

    Equal Employment Opportunity

    Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOCKnowYourRightsscreenreader10_20.pdf

     

    Privacy Notice

    Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

     

    Other facts

    Tech stack
    Utilization Management,Acute Hospital Case Management,Interpersonal Skills,Professional Ethics,Coding,Billing,Self-Funded Plans,HMO Plans,ERISA,HIPAA Guidelines

    About Prime Healthcare Management Inc

    About Prime Healthcare and Prime Healthcare Foundation: Prime Healthcare is an award-winning health system operating 51 hospitals and more than 360 outpatient locations in 14 states, providing over 2.5 million patient visits annually. It is one of the nation's leading health systems, with nearly 57,000 employees and affiliated physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Based in Ontario, California, Prime Healthcare is nationally recognized for award-winning quality care and has been named a 10 Top and 15 Top Health System by Truven Health Analytics. Its hospitals have been named among the nation's "100 Top Hospitals" 69 times and have received more Patient Safety Excellence Awards from Healthgrades than any other health system in the past eight years. To learn more, please visit primehealthcare.com.

    Team size: 10,001+ employees
    LinkedIn: Visit
    Industry: Hospitals and Health Care

    What you'll do

    • The Utilization Review Nurse LVN is responsible for coordinating and overseeing referral distribution and tracking. They assist in monitoring productivity and provide training to new staff.

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    Frequently Asked Questions

    What does Prime Healthcare Management Inc pay for a Utilization Review Nurse LVN?

    Prime Healthcare Management Inc offers a competitive compensation package for the Utilization Review Nurse LVN role. The salary range is USD 69k - 90k per year. Apply through Clera to learn more about the full compensation details.

    What does a Utilization Review Nurse LVN do at Prime Healthcare Management Inc?

    As a Utilization Review Nurse LVN at Prime Healthcare Management Inc, you will: the Utilization Review Nurse LVN is responsible for coordinating and overseeing referral distribution and tracking. They assist in monitoring productivity and provide training to new staff..

    Why join Prime Healthcare Management Inc as a Utilization Review Nurse LVN?

    Prime Healthcare Management Inc is a leading Hospitals and Health Care company. The Utilization Review Nurse LVN role offers competitive compensation.

    Is the Utilization Review Nurse LVN position at Prime Healthcare Management Inc remote?

    The Utilization Review Nurse LVN position at Prime Healthcare Management Inc is based in Ontario, California, United States. Contact the company through Clera for specific work arrangement details.

    How do I apply for the Utilization Review Nurse LVN position at Prime Healthcare Management Inc?

    You can apply for the Utilization Review Nurse LVN position at Prime Healthcare Management Inc directly through Clera. Click the "Apply Now" button above to start your application. Clera's AI-powered platform will help match your profile with this opportunity and guide you through the application process. You can also learn more about Prime Healthcare Management Inc on their website.