LVN - Utilization ReviewLocation: Pearland Administrative Office Department: Utilization Management Job Type: Full Time COMPANY PROFILEKelsey-Seybold Clinic. Changing theWay Health Cares.
Kelsey-Seybold Clinic is Houston's premier multispecialty group practice, founded in 1949 by Dr. Mavis Kelsey. With 19 clinic locations and more than 400 physicians, Kelsey-Seybold provides medical care in 55 medical specialties and is home to a nationally accredited Breast Diagnostic Center, Endoscopy Center, Infusion Center and Cancer Center. Our mission is to provide our team members with exceptional opportunities for professional and personal growth. JOB SUMMARYThe Utilization Review LVN nurse will perform documentation review for medical necessity and benefit correlation of requested medical and surgical procedures, services and admissions for HMO, PPO and POS products. The UR LVN nurse will serve as facilitator of communication with clinic, payor and other customers.
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS(A = basics; B = preferred)
Licensed Vocational Nurse, CEU requirement.
Two years varied medical/surgical experience. Computer and Coding experience.
TX LVN license, Valid Driver's license
Good organization and communication skills.
HMO, PPO and POS insurance knowledge.