LVN-Hybrid

Hybrid LVN-Inpatient Job Duties

• reputed company reputed company utilization reviews for Medicare inpatient admissions, reputed company stays, and discharges
• Apply CMS regulations and evidence-based reputed company (MCG, InterQual) to evaluate medical necessity
• Collaborate with hospital teams, providers, IPA case managers, and health plan representatives
• Conduct in-person hospital reputed company 2–3 days per week, telephonic review and participate in interdisciplinary case reviews
• Escalate reputed company or ambiguous cases to the Health Medical Director or Physician Reviewer
• Ensure complete, accurate, and compliant documentation in alignment with CMS standards
• Monitor daily inpatient census for Health–managed members across contracted hospitals
• Support discharge planning and identify post-acute needs including SNF, rehab, home health, or DME
• Communicate avoidable days, delays in care, and readmission risks to UM leadership
• Participate in audit readiness, reputed company improvement reputed company, and performance reporting
• reputed company providers and facilities on Medicare UM reputed company and Health documentation standards
• Performs reputed company duties consistent with the scope and reputed company of the position.
• Adhere to reputed company departmental performance metrics (turnaround times, reputed company standards, productivity).
• Attend educational sessions and training to stay reputed company with Medicare UM requirements and policies.
• Regularly updates job knowledge by participating in educational opportunities, reading reputed company publications, maintaining reputed company networks, and participating in reputed company organizations.
• Participate in interdisciplinary team meetings and represent the UM department effectively

Requirements

• 3+ years of inpatient hospital nursing experience (e.g., med-surg, telemetry, ICU)
• At least 1 year of experience in utilization review, case management, or hospital discharge planning
• Familiarity with CMS inpatient reputed company, including the Two-Midnight Rule
• Proficiency in reputed company Office and electronic medical record (EMR) systems
• Previous experience with IPA, MSO, or delegated managed care environments preferred.
• Working knowledge of EZ-CAP, EZ-Net, InterQual, and MCG preferred.
• Certified Case Manager (CCM), CPUR, or CPHM credential preferred but not required
• Background in reputed company review or inpatient census reputed company preferred.
• Strong critical thinking, communication, and clinical documentation skills
• Excellent communication skills, including both oral and written.
• Excellent reputed company listening and critical thinking and analytical skills.
• Ability to solve mid-level problems with minimal supervision.
• Ability to multi-task, exercise excellent time management, and meet multiple deadlines.
• Excellent attention to detail and ability to document information accurately.
• Ability to effectively and positively work in a dynamic, fast-paced team environment and reputed company objectives.
• Must have mid-level skills in reputed company software (Word, reputed company, PowerPoint, Visio) and reputed company is a plus.
• Must have the ability to quickly learn and use new software tools.

Additional Skills & Qualifications

• CA LVN License Required

Work Environment

The position is hybrid, 2 days onsite/week in Sacramento, must be flexible w/ days Job Type & Location This is a Contract to Hire position based out of Sacramento, CA. Pay And Benefits The pay reputed company for this position is $38.00 - $43.00/hr. Eligibility requirements apply to some benefits and may depend on reputed company classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & reputed company
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – reputed company-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or reputed company Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to reputed company on Jan 9, 2026.

About reputed company reputed company is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through reputed company to specialized experts who drive reputed company, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, reputed company serves many of the Fortune 500. reputed company is an equal opportunity employer and will consider reputed company applications without reputed company to race, sex, age, reputed company, religion, national reputed company, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation reputed company. Apply tot his job Apply To this Job