Remote Utilization Management LPN/LVN

Do you want to work for a company that Forbes named one of the Top 50 Most Innovative Companies? Are you looking to fast-track your career with one of LinkedIn's top companies in the U.S.? If so, keep reading! Title of Job: Remote Utilization Management LPN/LVN Location: REMOTE (anywhere in the US) CSI Companies is hiring a Remote Utilization Management LPN/LVN for our Fortune 100 healthcare client in Minnetonka, MN. This job can be worked from anywhere in the US as long as you have high speed internet and a distraction-free home office area. Job Summary
The Remote Utilization Management LPN/LVN is primarily responsible for ensuring timely and accurate review of authorizations, helping maintain compliance with regulatory and health plan requirements, and supporting overall workflow efficiency. Pay : $18 - 20 an hour based on experience (overtime will be paid at 1.5 times the normal hourly pay rate).

Hours: Full Time - Monday-Friday 8am-5pm Why this Opportunity?

• Top ranked company in Fortune's "World's Most Admired Companies" 14 years in a row .
• This healthcare client is ranked number one in key attributes of reputation:
  • Innovation
  • People management
  • Social responsibility
  • Quality of Management
  • Financial soundness
  • Long-term investment value
  • Quality of products
  • Services and global competitiveness

Status: Short Term Consultant. This is a short-term consulting opportunity offering the chance to gain experience with a Fortune 100 organization on high-impact initiatives. Strong performers may be considered for extensions or future opportunities based on business needs, as many roles within the organization begin on a consulting basis.

Effective Date / Tentative Start Date: Interviewing Immediately Job Duties:

• Evaluate and manage prior authorization requests, including referrals, follow up services, and scheduled procedures
• Determine coverage decisions by applying medical necessity guidelines (such as InterQual) in alignment with plan benefits
• Document clinical determinations clearly and promptly within EPIC
• Serve as a point of contact for providers, delivering authorization decisions and requests for additional information via phone and written correspondence
• Adhere to regulatory standards, internal policies, and audit requirements to ensure compliance
• Assist with care coordination activities, including benefit explanations and redirection to appropriate services

Requirements

• Current, unrestricted LVN/LPN licensure in Texas or a Compact State
• Associate's degree or higher
• At least two years of hands-on clinical nursing experience, ideally within utilization management or a managed care setting
• Understanding of clinical workflows and medical terminology
• A reliable high-speed internet connection (the faster the better!)
• Ability to pass a background check and drug test
• Private, quiet, and distraction-free workspace in a room with a closed-door

Highly Preferred

• Large corporation experience
• Health plan / managed care / healthcare industry experience

WHO SHOULD APPLY?
If you have experience in utilization management, utilization review, prior authorization, or InterQual Criteria, we would love for you to apply! Apply to become part of the team that is not only changing people's lives for the better but changing the health care system for the next generations to come. About Us

The CSI Companies is a recruiting firm established in 1994 that has been awarded "Best of Staffing" for 8 years in a row. We provide outstanding services to the world's leaders in the healthcare field as well as other organizations. For consideration, please submit your resume with all of your relevant experience included on it for immediate consideration. Only those candidates identified for an interview will be contacted.

Benefits Offered:

• Weekly pay
• Medical, dental, and vision coverage
• Voluntary Life and AD&D coverage
• Paid Training
• Opportunity for advancement upon performance and availability

APPLY NOW and a recruiter will be in touch with you to schedule a phone screening!