Remote UM Nurse LPN/LVN - Care Management & Appeals
Integra Partners
Integra Partners is seeking an LPN/LVN with experience in the managed care UM environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. You will collaborate with our Medical Director to conduct benefit and medical necessity reviews within a NCQA compliant UM program.
Responsibilities include approving eligible requests, referring non-criteria cases to the Medical Director, handling administrative and clinical appeals, and maintaining compliance with NCQA,
#J-18808-LjbffrVacancy posted 2 days ago
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Integra Partners
Las Vegas, NV3 days ago
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