Remote Utilization Review Nurse (LPN/LVN)
Integra Partners
Integra Partners is seeking an LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. You will collaborate with our Medical Director to review benefit and medical necessity within an NCQA-compliant UM program.
Responsibilities include authorizing eligible requests, referring non-eligible cases to the Medical Director, handling appeals, and ensuring compliance with NCQA, CMS and state standards.
#J-18808-LjbffrVacancy posted 2 days ago
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