Remote UM Nurse LPN - Utilization Reviews & Appeals
Paterson, Passaic County, New Jersey, 07501, USA
Listed on 2026-11-01
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Nursing
Nursing Home, Healthcare Nursing
Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals in a managed care UM program. This role collaborates with the Medical Director on benefit and medical necessity reviews, aligned with NCQA standards.
The UM Nurse will review requests, approve those meeting criteria, and refer others to leadership. This position requires nursing experience and familiarity with Inter Qual, CMS guidelines, and payer policies.
We are looking to fill the Remote UM Nurse LPN - Utilization Reviews & Appeals position at Integra Partners in Clifton, TX, United States.
Please review the full job details above before applying.
If your experience matches this role, we encourage you to apply.
All applications are reviewed carefully by our team.
The position is based in Clifton, TX, United States.
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