Mark Powers

LVN Utilization Review Remote HealthCare Support is actively seeking a LVN Utilization Review Remote  to fill an opening in Houston, Texas. Daily Responsibilities for LVN Utilization Review Remote:

• Provide support in the development and generation of the UM adverse determination letters. Review of adverse determination letters for accuracy and appropriateness of Medical Director documentation to ensure compliance to all regulatory requirements prior to mailings.
• Monitor letter generation and mailing accuracy of all adverse determination letters to ensure compliance while accurately entering the required information into the managed care platform, adhering to UM policies and procedures.
• Telephonic outreach to providers to obtain additional information as directed by the Medical Director
• Wed-Fri 10-6, Sat/Sun 8-5

Required Qualifications for LVN Utilization Review Remote:

• LVN current Texas License 
• Three years clinical experience in acute setting. and at least 2 years of UR/UM
• Highlight lines of business worked- Texas Medicaid, CHIP, marketplace
• Microsoft Office (Word, Outlook, Excel)

 Benefits for LVN Utilization Review Remote:

• Health Insurance
• Dental Insurance
• Life Insurance
• Employee Assistance Program (EAP)
• Access to Investment Accounts
• Career and educational tools within our Ingenovis ACT (advocacy) Program

Pay Details: $30- $34.62/ Hour Interested in Being Considered? If you are interested in applying to this position, please click Apply Now for immediate consideration. For additional questions, you may contact us at [email protected]. Please include your phone number, Job Title, and location and our recruiters will reach out. Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

HIRING: Clinical Case Manager - RN / LCSW HealthCare Support is actively seeking a Clinical Case Manager - RN / LCSW to fill an opening for a Managed Care Company Daily Responsibilities for Clinical Case Manager - RN / LCSW:

• Managing a case load for healthcare members with long term care needs.
• Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver’s license.
• Member assessments and notes.
• Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development.
• Monitor delivery of services and follow-up with members, caregivers, or provider s through in person visits and telephonic contact
• Authorize and coordinate referral for services.
• Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care.
• Assist in coordinating the development of informal or voluntary services to integrate into the member care plan Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services!
• Assist member with filing and resolving complaints and appeals.

Required Qualifications for Clinical Case Manager - RN / LCSW:

• Clear and active NC RN license
• 2+ years of Care Management experience
• Experience with electronic medical health records
• Microsoft office, Experience with electronic medical health records
• Valid driver's license with auto insurance
• Graduate from accredited school of nursing

Benefits for Clinical Case Manager - RN / LCSW:

• Immediate enrollment in Health Insurance
• Dental Insurance
• Life Insurance
• Employee Assistance Program (EAP)
• Access to Investment Accounts
• Career and educational tools within our Ingenovis ACT (Advocacy) Program

Other Details:

• Length of Assignment: 6+ month contract to permanent
• Pay Details: $37 to $41 an hour
• Shift: M-F 8-5
• Location: Field in North Carolina

Interested in being considered? If you are interested in applying to this position, please click Apply Now for immediate consideration. For additional consideration, please email a copy of your resume to [email protected] with your phone number, the job title and location, and our recruiters will reach out. Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.