Remote UM Nurse: Utilization Review & Appeals (LPN/LVN)
Integra Partners
Tallahassee, FL
- Remote job
Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This role collaborates with our Medical Director to perform benefit and medical necessity reviews within an NCQA-compliant UM program. The UM Nurse’s responsibilities include pre-service/post-service reviews, approvals, referrals to Medical Director, and handling appeals while ensuring compliance with NCQA, CMS and state standards. #J-18808-Ljbffr Integra Partners
Vacancy posted 2 days ago
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CHRISTUS Health
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Fairfield, CAa month ago
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