ApolloMed

<div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Job Title: Utilization Management Review Nurse </span></div><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Department: Health Services - UM</span></div><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;"><strong style="background-repeat: no-repeat;outline: none;font-weight: 600;">About the Role:</strong></span></div><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Astrana Health is looking for an experienced Utilization Review Nurse who will work remote, based out of Texas. This position will typically work M-F from 8:30 a.m. to 5 p.m. We also require weekend and holiday coverage if there is a business need. </span></div><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;"><strong style="background-repeat: no-repeat;outline: none;font-weight: 600;">What You’ll Do:</strong></span></div><ul><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Complete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment</span></li><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Refer cases to Medical Directors as needed/appropriate</span></li><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Maintain knowledge of state and federal regulations and accreditation standards</span></li><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Comply with internal policies and procedures</span></li><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Perform any other job duties as requested</span></li></ul><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;"><strong style="background-repeat: no-repeat;outline: none;font-weight: 600;">Qualifications:</strong></span></div><ul><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Active and unrestricted LVN license in Texas</span></li><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Experience with Microsoft applications such as Word, Excel, and Outlook</span></li></ul><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;"><strong style="background-repeat: no-repeat;outline: none;font-weight: 600;">You’ll be Great for this Role If:</strong></span></div><ul><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Two (2) years of health plan, IPA or MSO experience</span></li><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Strong interpersonal skills</span></li><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Ability to collaborate with co-workers, senior leadership, and other management</span></li><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Experience educating and training staff</span></li></ul><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;"><strong style="background-repeat: no-repeat;outline: none;font-weight: 600;">Who We Are</strong></span></div><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise in order to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient. </span></div><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Our platform currently empowers over 12,000 physicians to provide care for over 1.3 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise in order to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system. </span></div><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;"><strong style="background-repeat: no-repeat;outline: none;font-weight: 600;">Environmental Job Requirements and Working Conditions:</strong></span></div><ul><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">This position is on a hybrid schedule. The office is located in Monterey Park.</span></li><li><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">The target pay range for this role is $28 - $40 per hour. </span></li></ul><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@networkmedicalmanagement.com to request accommodation.</span></div><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;"><strong style="background-repeat: no-repeat;outline: none;font-weight: 600;">Additional Information: </strong></span></div><div style="background-repeat: no-repeat;outline: none;margin: 10.0px 0.0px;font-family: 'Open Sans' , Helvetica;font-size: 14.0px;font-weight: 400;line-height: 20.0px;color: rgb(38,50,56);font-style: normal;letter-spacing: normal;text-indent: 0.0px;text-transform: none;word-spacing: 0.0px;"><span style="background-repeat: no-repeat;outline: none;font-family: 'times new roman' , times;font-size: 12.0pt;">The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change. </span></div>