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Retrospective Review LPN
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Phoenix, AZ Phoenix, Arizona |
About this job
Retrospective Review LPN (licensed Practical Nurse) Excellent Health Plan. Position Summary for the Retrospective Review LPN Performs case processing, clinical evaluation and completion of ER PLP reconsiderations from receipt to adjudication. Utilizes clinical knowledge to evaluate and assess the clinical necessity of ER PLP reconsiderations. Essential Functions of the Retrospective Review LPN Communicates with coordinators and Medical Directors, the case disposition of ER PLP reconsiderations. Reviews medical records against PLP guidelines and recommends a case disposition. Applies clinical knowledge in the assessment, evaluation and interpretation of clinical notes submitted by the provider. Evaluates the medical record so that patient age,