WelbeHealth is transforming senior care by providing an all-inclusive healthcare option for vulnerable seniors. The Utilization Management LVN is responsible for auditing authorization requests and ensuring compliance with medical guidelines to provide timely and quality care.
Responsibilities
- Chart audits of items including but not limited to consult summaries, imaging results, and procedure summaries to determine if additional follow up services are requested
- Oversee departmental clinical inboxes, email inboxes, and fax queues to ensure appropriate handling of documents and authorization requests
- Identify, document, and correct inconsistencies and gaps in participants’ charts with authorizations in the UM system
- Review prior authorization requests for medical necessity and alignment with participants’ care plans, including routine office visits, procedures, and DME
Skills
- Minimum of one (1) year of chart auditing or UM review experience
- Knowledgeable in areas of Medicare and Medicaid UM regulations
- Unencumbered LVN licensure
Benefits
- Medical insurance coverage (Medical, Dental, Vision) starting day one of employment
- Work/life balance – we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days
- Advancement opportunities - We’ve got a track record of hiring and promoting from within, meaning you can create your own path!
- 401(k) match
- Comprehensive healthcare coverage
- A broad range of additional benefits
Company Overview
Unlocking the full potential of our most vulnerable seniors with empathy and love. It was founded in 2015, and is headquartered in Menlo Park, California, USA, with a workforce of 501-1000 employees. Its website is http://welbehealth.com/.Company H1B Sponsorship
WelbeHealth has a track record of offering H1B sponsorships, with 1 in 2025, 1 in 2024, 2 in 2023, 1 in 2022, 2 in 2021. Please note that this does not guarantee sponsorship for this specific role.