Utilization Management LVN

Texas Connect, Inc. (TCI) is a Management Services Organization (MSO). ‍ As an MSO, we are dedicated to providing business and administrative services for healthcare providers, such as medical practices and hospital systems, allowing them to focus on patient care. TCI handles crucial backend functions, such as Information Technology, Billing, and Medical Coding. This allows our client healthcare organizations to delegate these and other essential, but non-medical tasks to TCI to improve operational efficiency. https://www.texasconnectinc.com

There are 3 open positions for this role.

The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) throughout admission and performs concurrent reviews/retrospective reviews according to guidelines. In addition, the UM LVN delegates to UM RN initial reviews and determines the medical necessity of requests by performing first level reviews. The UM LVN ensures a process that is efficient for providing care, ensuring timely and appropriate levels of care for the incoming patients. UM LVN is responsible for preparing cases for Physician Advisor for 2nd level review. This position will be hybrid with remote and in-office assignment.