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 9/22/2026full-timeMontebello • California • United StatesJuniorMid-Level💰 $31 - $39 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Utilization Management and prior authorization processes, ensuring compliance with medical necessity and coverage guidelines. Proficient in evaluating treatment plans for appropriateness and efficiency in both inpatient and outpatient settings.

Highest-signal resume keywords

Licensed Vocational NurseUtilization Management ExperiencePrior Authorization ExpertiseBLS CertificationMedical Necessity Evaluation

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Authorization ReviewTreatment Plan EvaluationMedical Guideline ApplicationBenefit DeterminationInpatient Service AssessmentOutpatient Service Assessment

Certifications & Qualifications

Licensed Vocational NurseBLS Certification

Industry Keywords

Managed CareHealth Plan GuidelinesMedical NecessityCoverage 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
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
May qualify for discretionary bonuses or incentives