About the role
WelbeHealth is hiring a Utilization Management LVN in Los Angeles, CA to review and audit authorization requests so seniors in its PACE program get timely, compliant, cost-effective care. You'll audit charts, manage clinical inboxes and fax queues, and review prior authorizations for medical necessity against participants' care plans. Pay is $35.87–$47.36/hour plus bonus, with strong benefits and real advancement opportunities.
Responsibilities
- Audit charts (consult summaries, imaging and procedure results) to flag needed follow-up
- Oversee clinical inboxes, email and fax queues for proper handling of authorization requests
- Identify, document and correct gaps between participants' charts and authorizations
- Review prior authorizations for medical necessity — office visits, procedures and DME
Requirements
- Unencumbered LVN licensure
- Minimum 1 year of chart auditing or UM review experience
- Knowledge of Medicare and Medicaid UM regulations
- Strong documentation and attention to detail
What we offer
- $35.87–$47.36/hour plus bonus
- Medical, dental and vision; 401(k) with match
- 17 days PTO, 12 holidays and sick time
- Advancement opportunities with a promote-from-within track record