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What You'll Actually Do:
- Evaluate requests for medical necessity, appropriate level of care, and benefit coverage.
- Review outpatient, inpatient, and post-service requests across care settings.
- Escalate cases that need advanced review and support IRO referrals.
What You Bring to Our Team:
- Graduate of an accredited LVN/LPN nursing program with a current U.S. license.
- 1-2 years of recent clinical experience in acute care, med-surg, ICU/ED, or similar.
- Working knowledge of MCG, NCCN, and UM documentation systems.
Benefits:
- Competitive base salary and benefits effective day one.
- Comprehensive medical and dental through our own health solutions.
- Professional development with clear career progression and learning budgets.
Personify Health
Personify Health created the first and only personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. Their mission-driven culture empowers diverse perspectives to drive real impact on people's health.