Utilization Management LVN (Remote - CA License)

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Join our dynamic Utilization Management team as an LVN Case Manager where you will assess requests against clinical guidelines and effectively communicate decisions to providers and patients. This role involves performing initial reviews and working with various healthcare criteria within outpatient cases.

Conduct initial reviews of outpatient cases, averaging 40 cases per day, with expectations in the high 30s. Ensure compliance with turnaround times and accuracy standards. Coordinate with contracted providers and obtain appropriate contracts as necessary. Identify cases requiring additional case management and coordinate care with relevant departments. Collaborate with internal staff to ensure seamless care coordination.