Remote UM Nurse - Utilization Review & Appeals (LPN/LVN)
Integra Partners
Columbus, OH
- Remote job
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-Ljbffr Integra Partners
Vacancy posted 3 days ago
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