LVN UM Review Clinician, Prior Authorization

Molina Healthcare is currently seeking a passionate LVN UM Review Clinician, Prior Authorization to join our dynamic team. The ideal candidate will bring expertise in medical review, prior authorization, and clinical knowledge to our organization. This position is an excellent opportunity to work closely with a team of healthcare professionals and to make a positive impact on our members’ lives. The successful candidate should possess a current LVN license, a minimum of one year of clinical experience, and a strong commitment to patient-centered care. If you have a passion for providing quality care and are looking for an exciting new challenge, we invite you to apply today!

Responsibilities:

1. Manage prior authorizations for medical services and clinical supplies in accordance with Molina Healthcare policies and procedures.
2. Ensure quality and timely completion of medical reviews and prior authorization requests.
3. Maintain a knowledge of current clinical practice guidelines, standards, and protocols.
4. Provide clinical education to other areas of the organization to ensure Molina Healthcare’s compliance with state and federal regulations.
5. Monitor and track utilization of medical services and supplies to ensure cost-effectiveness and quality of care.
6. Collaborate with other healthcare professionals to ensure continuity of care for members.
7. Participate in quality improvement initiatives to improve clinical care for members.
8. Stay informed of emerging trends in healthcare and recommend changes to ensure Molina Healthcare’s policies and procedures remain up-to-date.

According to JobzMall, the average salary range for a LVN UM Review Clinician, Prior Authorization in Long Beach, CA, USA is $61,000 to $79,000 per year. This range depends on the amount of experience the individual has, the type of organization they work for, and the location of the position.

Molina Healthcare is a managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare.