Licensed Vocational Nurse, Utilization Management

AltaMed Health Services

. Provide routine review of authorization requests from all lines of business using respective national/state, health plan, and nationally recognized guidelines .

Posted 10/3/2026full-timeMontebello • California • United StatesJuniorMid-Level💰 $31 - $39 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Utilization Management and prior authorization processes, with a strong focus on evaluating medical necessity and adherence to coverage guidelines. Holds a valid Licensed Vocational Nurse license and BLS certification, ensuring compliance with healthcare standards.

Highest-signal resume keywords

Licensed Vocational NurseUtilization ManagementPrior AuthorizationBLS CertificationManaged Care Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Necessity EvaluationCoverage Guideline ReviewInpatient Service AssessmentOutpatient Service AssessmentTreatment Plan Review

Certifications & Qualifications

BLS CertificationLicensed Vocational Nurse License

Industry Keywords

Managed CareAuthorization RequestsHealth Plan GuidelinesNational GuidelinesState Guidelines

About the role

Key responsibilities & impact

Provide routine review of authorization requests from all lines of business using respective national/state, health plan, and nationally recognized guidelines
Review proposed hospitalization, home care, and inpatient/outpatient treatment plans for medical necessity and efficiency with coverage guidelines
Determine the medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination

Requirements

What you’ll need

Current valid License as a Licensed Vocational Nurse
Minimum of 2 years of managed care experience in Utilization Management/prior authorization required
A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines

Benefits

Comp & perks

Medical, Dental and Vision insurance
403(b) Retirement savings plans with employer matching contributions
Flexible Spending Accounts
Commuter Flexible Spending
Career Advancement & Development opportunities
Paid Time Off & Holidays
Paid CME Days
Malpractice insurance and tail coverage
Tuition Reimbursement Program
Corporate Employee Discounts
Employee Referral Bonus Program
Pet Care Insurance
Discretionary bonuses or incentives may apply