About Us:
At Workwarp, we're revolutionizing the healthcare industry by integrating comprehensive health programs across the entire continuum of care. Our mission is to provide innovative solutions that empower individuals to take control of their health and well-being. We're committed to fostering a collaborative and inclusive work environment that encourages growth, learning, and creativity. If you're passionate about making a meaningful impact in the lives of others, join us on this exciting journey!
Job Summary:
We're seeking an experienced Licensed Vocational Nurse (LVN) to join our team as a Utilization Management (UM) Delegation Oversight Specialist. In this role, you'll play a critical part in ensuring the highest quality of care by coordinating Health Plan Delegation Oversight audits and performing internal quality reviews for Case Management and Utilization Management. As a remote worker, you'll enjoy the flexibility to work from anywhere within the U.S. while taking on challenging responsibilities that will help you grow professionally and personally.
Key Responsibilities:
- Pre-audit documentation preparation: Prepare and submit pre-audit documentation as outlined on Health Plan audit tools to ensure seamless audit processes.
- Communication and collaboration: Communicate effectively with Health Plan auditors, internal stakeholders, and external partners to gather necessary documentation and meet audit requirements.
- Compliance audit reviews: Facilitate onsite, virtual, or desktop compliance audit reviews to ensure adherence to regulatory requirements.
- Performance improvement activities: Participate in performance improvement activities to identify areas for growth and implement process enhancements.
- Internal audit and quality reviews: Conduct comprehensive internal audits of the end-to-end utilization management process and focused internal audits of specific elements or process changes based on identified trends or new process implementations.
About You:
We're looking for a highly motivated and detail-oriented LVN with a passion for quality improvement and patient-centered care. As a successful candidate, you'll possess:
Essential Qualifications:
- Education: Graduation from an accredited Licensed Vocational/Practical Nurse program or completion of vocational nursing program through the CA Board of Nursing.
- License: Current LVN/LPN license.
- Experience: 2 years of clinical experience working as an LVN/LPN and 1 year of utilization management experience, especially Prior Authorization.
Preferred Qualifications:
- Experience: 3 years of experience working as an LVN/LPN, 2 years of care management, utilization review, or discharge planning experience, and experience in an HMO or Managed Care setting.
- Knowledge: Demonstrated base knowledge of requirements for Medicare, Medi-Cal, and Commercial lines of business.
What We Offer:
We're committed to providing a comprehensive benefits package, competitive salary, and opportunities for growth and development. As a remote worker, you'll enjoy the flexibility to work from anywhere within the U.S. while taking on challenging responsibilities that will help you grow professionally and personally. Our benefits include:
- Competitive salary: A competitive salary based on local labor markets, education, work experience, certifications, and other factors.
- Comprehensive benefits package: A range of benefits, including medical, dental, and vision coverage, as well as 401(k) contribution and equity stock purchase.
- Professional development opportunities: Training, mentorship, and opportunities for growth and advancement within the organization.
- Flexible work arrangements: The flexibility to work from anywhere within the U.S. and create a work-life balance that suits your needs.
Why Join Us:
At Workwarp, we're passionate about making a meaningful impact in the lives of others. We believe that everyone deserves access to high-quality healthcare, regardless of their background or circumstances. As a member of our team, you'll have the opportunity to work with a talented and dedicated group of professionals who share your values and commitment to excellence. Together, we'll create a healthier, more equitable world for all.
How to Apply:
If you're ready to take on a challenging and rewarding role, apply now! We're excited to hear from you and learn more about your qualifications and experience. Don't miss this opportunity to join our team and make a difference in the lives of others.
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