Remote UM Nurse LPN - Utilization Reviews & 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 program. This role collaborates with the Medical Director on benefit and medical necessity reviews, aligned with NCQA standards.
The UM Nurse will review requests, approve those meeting criteria, and refer others to leadership. This position requires nursing experience and familiarity with InterQual, CMS guidelines, and payer policies.
#J-18808-LjbffrVacancy posted 3 hours ago
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