Remote LPN UM Nurse: Managed Care & Appeals

Integra Partners

Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals in a managed care UM environment. The role collaborates with the Medical Director to ensure benefit and medical necessity reviews meet NCQA-compliant UM standards.

The UM Nurse will review pre/post service requests against plan benefit language, NCDs/LCDs, and criteria such as InterQual, CMS policies, and other medical policies.

#J-18808-Ljbffr

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Vacancy posted 3 days ago

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