Kelsey-Seybold

  • LVN - Utilization Review

    Location US-TX-Pearland
    Posted Date 3 months ago(4/2/2018 4:44 PM)
    Job ID
    2018-18820
    Category
    Nursing
  • Overview

    LVN Utilization Review

    Location: Pearland Administrative Office

    Department: Utilization Management

    Job Type: Full Time

     

    COMPANY PROFILE

    Kelsey-Seybold Clinic. Your Doctors for Life.

    Since 1949, Kelsey-Seybold Clinic has served its patients with one goal in mind – combine the expertise of physicians in a variety of medical specialties, with the close personal care of a family doctor. Kelsey-Seybold is Houston’s largest community-based physician group, caring for more than 400,000 patients. With 19 clinic locations, we are growing to meet the health care needs of our diverse patient population. Our mission is to provide our team members with exceptional opportunities for professional and personal growth.​​

     

    JOB SUMMARY

    The 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)

     

    Education

    A.

    Licensed Vocational Nurse, CEU requirement.

     

    B.

     

    Experience

    A.

    Two years varied medical/surgical experience. Computer and Coding experience.

     

    B.

     

     

    Licenses

    A.

    TX LVN license, Valid Driver’s license

    B.

     

    Special   Skills

    A.

    Good organization and communication skills.

    B.

     

     

    Other

    A.

    HMO, PPO and POS insurance knowledge.

    B.

     

     

    WORKING ENVIRONMENT

    Office


     
     

    Responsibilities

     

     

    Options

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