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Lancesoft
Temporary Grievance & Appeals Nurse (LVN)Lancesoft • Rancho Cucamonga, CA, US
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Temporary Grievance & Appeals Nurse (LVN)

Temporary Grievance & Appeals Nurse (LVN)

Lancesoft • Rancho Cucamonga, CA, US
30+ days ago
Job type
  • Full-time
  • Quick Apply
Job description
Title: Temporary Grievance & Appeals Nurse (LVN)
Work location: Rancho Cucamonga, CA 91701
Payrate: $30.72 /HR
Duration: Six-month Assignment

Requirements:
  • Standard Background & Drug Screen
  • +Professional license verification
  • + MVR (driving record)

Responsibilities:
Qualifications:
Education & Requirements
  • Two (2) years or more case management, utilization management in managed care setting or related experience in a health care delivery setting
    • Experience in an HMO or experience in managed care setting preferred
  • High school diploma or GED required
    • Associate s degree from an accredited institution preferred
  • Minimum possession of an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians required
Key Qualifications
  • Must have a valid California Driver's License
  • Working knowledge and understanding of:
    • Member and Provider legal rights to access the grievance and appeals resolution process, within the respective Provider Organization, DHCS, DMHC, and Client and IEHP
    • Outside agencies and resources such as CCS, Client, DMHC, or DHCS
    • Regulatory guidelines surrounding grievances and appeals per Client, DHCS, and DMHC and NCQA
  • Microcomputer applications: spreadsheet, database, and word processing. Excellent written and verbal communication skills
  • Proven ability to:
    • Demonstrate critical thinking and strong problem-solving capability
    • Demonstrate a commitment to incorporate LEAN principles into daily work
    • Possess strong attention to detail
    • Prioritize work to ensure adherence to project deadlines
    • Effectively escalate issues as identified, following established protocols
    • Maintain a positive attitude and ability to work in a team setting
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Temporary Grievance & Appeals Nurse (LVN) • Rancho Cucamonga, CA, US

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