Integra Partners seeks an experienced LPN/LVN to conduct pre-service and post-service utilization reviews and appeals within a NCQA-compliant UM program, collaborating with our Medical Director.
The role emphasizes applying federal/state mandates, plan benefits, and guidelines such as InterQual and CMS to determine medical necessity, with responsibilities including approvals, referrals, and handling appeals. Remote opportunities available and strong team culture.
#J-18808-LjbffrUtilization Management Nurse in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.