Medical Case Manager - Concurrent Review

Job Description

Sunshine Enterprise USA LLC, an industry-leading Staffing and Recruitment Firm, is seeking a dedicated Medical Case Manager - Concurrent Review (LVN) to join our dynamic team. In this role, you will review and process requests for medical services, assess the appropriateness of care, and work collaboratively with patients, families, and healthcare professionals to ensure quality outcomes.

Responsibilities

• Review and evaluate medical service requests based on established criteria.
• Collaborate with the interdisciplinary team to develop and monitor individualized care plans.
• Advocate for patients to ensure timely and appropriate care, treatment, and funding.
• Document patient progress, care plans, and decisions accurately and thoroughly.
• Establish effective communication with healthcare providers and community agencies.

Requirements

• High School diploma or equivalent required.
• Current LVN license in California with 3 years of Clinical Nursing Experience.
• Experience in Managed Care, with preferred experience in Concurrent Review.
• Strong knowledge of medical terminology, insurance benefits, coding systems, and utilization management guidelines.

Benefits

• Competitive salary ranging from $33.65 to $54.93 per year.
• Health, dental, vision, and life insurance coverage.
• 401(k) savings plan and weekly paychecks.
• Awards, recognition programs, and career development opportunities.