Where You’ll Work Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health – one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. Our 130+ clinics across the state of California deliver high-quality, patient-centric care with an emphasis on humankindness. Through affiliations with Dignity Health hospitals, along with our joint ventures and partnerships, we offer a robust, state-of-the-art health care delivery system in the communities we serve .We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service. One Community. One Mission. One California Job Summary and Responsibilities As our Utilization Review LVN Precert I, your focus will be to provide high quality, cost-effective care which will enable patients to achieve maximum medical improvement while receiving care deemed medically necessary. The LVN assists in determining appropriateness, quality and medical necessity of referral requests using pre-established guidelines. This position supports the Medical Group in effective management of the managed care patient. This position may be assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review. To be successful in this role, you will effectively manage patient charts, demonstrating enthusiasm, efficiency, and empathy, while ensuring accurate application of criteria to support optimal patient care and operational flow. - Conducts pre-authorization referral reviews, following workflow as written, document criteria to make determination or recommendation and process the referral in a timely manner.- Manages assigned queues on a daily basis working oldest referrals first to assure 98% compliance with ICE timeframes.- Follows job work aide in sequence of performing job, including checking eligibility on health plan websites. Demonstrates 100% accuracy of identification of Medical Group member before referral review is initiated.- Determines correct type of referral and utilizes correct criteria in performing review and documents appropriate sections with 95% accuracy. Researches correct information and/or uses pend letter appropriately when facts are needed to reach determination.- Preps case thoroughly, concisely and clearly for physician review. Researches EMR, criteria, medical policy and past history of member to detail case cleanly for MD. Watches for follow up and processes denials as indicated, correct identification of reasons for denial.- Recommends and coordinates interventions to facilitate high quality, cost-effective care, monitoring treatment, progress and outcomes of patients. ***This position is work from home within California. Job Requirements Minimum Qualifications: - 0-3 years of LVN experience.- Graduation from an accredited Licensed Vocational Nursing program.- Clear and current CA Licensed Vocational Nurse (LVN) license.- Familiarity with healthcare regulations, including HIPAA, CMS, and state-specific requirements- Knowledge of UM operations.- Strong knowledge nursing requirements in a clinical setting.- Knowledge of utilization management programs as related to pre-set protocols and criteria.- Knowledge of health plans, medical specialty procedures and diagnoses.- Ability to work within an interdisciplinary structure and function independently in a fast paced environment while managing multiple priorities and meeting deadlines.- Ability to apply clinical judgment to complex medical situations and make quick decisions.- Ability to read and interpret benefit contract specifications.- Ability to understand and follow established criteria and protocols used in managed care functions.- Strong organization skills.- Effective telephone and computer data entry skills.- Ability to formulate ideas and solutions into appropriate questions and assess/interpret the verbal responses Preferred Qualifications: - Physician group experience preferred.- Experience at meeting deadlines by prioritizing workflow preferred.- - General knowledge of UM and Managed Care preferred.- Use of InterQual guidelines preferred.- Knowledge of California health plans and differences between commercial and advantage plans preferred.- Familiarity with business practices and protocols with ability to access data and information using automated systems preferred.- Ability to communicate effectively with coworkers, members, their families, physicians and health care providers preferred.

Where You’ll Work Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health – one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. Our 130+ clinics across the state of California deliver high-quality, patient-centric care with an emphasis on humankindness. Through affiliations with Dignity Health hospitals, along with our joint ventures and partnerships, we offer a robust, state-of-the-art health care delivery system in the communities we serve .We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service. One Community. One Mission. One California Job Summary and Responsibilities As our Utilization Review LVN, your focus will be to provide high quality, cost-effective care which will enable patients to achieve maximum medical improvement while receiving care deemed medically necessary. The LVN assists in determining appropriateness, quality and medical necessity of referral requests using pre-established guidelines. This position supports the Medical Group in effective management of the managed care patient. This position may be assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review. To be successful in this role, you will effectively manage patient charts, demonstrating enthusiasm, efficiency, and empathy, while ensuring accurate application of criteria to support optimal patient care and operational flow. - Manages assigned queues on a daily basis working oldest referrals first to assure 98% compliance with ICE timeframes.- Follows job work aide in sequence of performing job, including checking eligibility on health plan websites. Demonstrates 100% accuracy of identification of Medical Group member before referral review is initiated.- Determines correct type of referral and utilizes correct criteria in performing review and documents appropriate sections with 95% accuracy.- Researches correct information and/or uses pend letter appropriately when facts are needed to reach determination.- Preps case thoroughly, concisely and clearly for physician review. Researches EMR, criteria, medical policy and past history of member to detail case cleanly for MD. Watches for follow up and processes denials as indicated, demonstrating correct identification of reasons for denial.- Recommends and coordinates interventions to facilitate high quality, cost-effective care, monitoring treatment, progress and outcomes of patients. ***This position is work from home within California. Job Requirements Minimum Qualifications: - 3 years Utilization Management (UM) experience.- 5 years LVN experience.- Clear and current CA Licensed Vocational Nurse (LVN) license.- Strong knowledge nursing requirements in a clinical setting.- Knowledge of utilization management programs as related to pre-set protocols and criteria.- Knowledge of health plans, medical specialty procedures and diagnoses.- Ability to work within an interdisciplinary structure and function independently in a fast paced environment while managing multiple priorities and meeting deadlines.- Ability to apply clinical judgment to complex medical situations and make quick decisions.- Ability to read and interpret benefit contract specifications.- Ability to understand and follow established criteria and protocols used in managed care functions.- Strong organization skills.- Effective telephone and computer data entry skills.- Ability to formulate ideas and solutions into appropriate questions and assess/interpret the verbal responses. Preferred Qualifications: - Experience at meeting deadlines byprioritizing work flow preferred.- Physician group experience preferred.- General knowledge of UM and Managed Care preferred.- Use of InterQual guidelines preferred.- Knowledge of California health plans and differences between commercial and advantage plans preferred.- Familiarity with business practices and protocols with ability to access data and information using automated systems preferred.- Ability to communicate effectively with coworkers, members, their families, physicians and health care providers preferred.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. - This role requires the nurse to exercise clinical judgment and perform the following duties: - Review and interpret clinical documentation obtained from medical records or systems. - Apply clinical decision-making to utilize appropriate clinical criteria and policies for post-service claims - Coordinate clinical resolutions independently, with clinician/MD support as required - Act as a resource for customer service and claims processing teams - Train new staff and provide cross-training to existing team members - Identify trends and provide feedback to leadership if discrepancies or potential fraudulent activities are identified - Remain current with applicable laws, regulations, and internal workflows to ensure full compliance with organizational and state-specific requirements Required Qualifications: - A minimum of 2–3 years of professional experience as a licensed - Registered Nurse (RN) Licensure in the state they reside - Strong analytical skills to assess medical claims Preferred Qualifications: - Computer proficiency, Microsoft Suite - Utilization Management experience Education: - Bachelor’s in Science and Nursing Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $29.10 - $62.32 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 04/13/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Requisition ID: 34817 At Terumo Blood and Cell Technologies, our 8,000+ global associates proud to come to work each day, knowing that what we do impacts the lives of patients around the world. For Terumo, for Everyone, Everywhere. We make medical devices and related products that are used to collect, separate, manufacture and process various components of blood and cells. With our innovative technologies and service offerings, we touch a patient’s life every second of every day and are committed to continuing to increase the number of patients we serve. Advancing healthcare with heart. With some of the best and brightest minds in the industry, an unmatched global footprint, comprehensive benefits and a distinct culture, Terumo Blood and Cell Technologies is a great place to work, grow and be part of a team that is focused on making a difference. Join us and help shape wherever we go next. You create your future and ours. The Medical Education Lead (MEL) will support the delivery and embedding of medical education in North America in order to develop the clinical skills, knowledge, confidence and competencies of the internal team and the health care professional’s community with the aim of increasing therapy awareness & adoption. The MEL will be a business partner who will engage in identifying and overcoming unmet medical needs especially related to apheresis and cell therapies. The MEL will act both internally and externally to develop therapy adoption programs together with North America (NA) thought leaders and prescribers. The MEL may be called on to support, participate and/or drive special projects, such as clinical trials, internal and external education and medical congresses. The MEL will respond to medical, scientific & clinical information requests with regards to high-level troubleshooting and procedure optimization. DUTIES AND RESPONSIBILITIES - Develops and maintains professional scientific relationships in areas critical to Terumo Blood and Cell Technologies (TBCT) with thought leaders and health care professional in key medical or blood centers, with medical professional associations and patient advocacy groups - Works with the sales and marketing team to build knowledge, confidence and competence to drive clinical excellence and help to achieve unmet medical needs in the field of Apheresis - Serves as a primary Medical Affairs contact involved with clinical/scientific information exchanges. These exchanges may be verbal, written or electronic inquiries from healthcare professionals. - Identifies opportunities and conducts formal presentations to essential groups as requested by medical and technical healthcare professionals, including key accounts, hospital therapeutic committee members in accordance with company policies, applicable laws, regulatory guidelines, and ethical standards. - Maintains expert knowledge and understanding of clinical, scientific, and technical information in areas critical to TBCT through collaboration with the global medical affairs organization, attending conferences and networking with experts. - Support the commercialization team and global product marketing where appropriate, providing input as needed in product innovation and unmet medical needs. - Active participation in developing tools, resources e.g. training material. - Attends & provides coverage at national & regional medical education venues (congresses, conferences, symposia) and brings back medical insights to key internal stakeholders for accurate planning. - Responds to and tracking medical information requests from healthcare professionals and decision makers with accurate, unbiased, balanced and timely answers. - May lead and/or coordinate special projects as it relates to building scientific & medical competencies within the organization, such as internal training of sales & marketing, scientific symposium program, presentation and slide kit development. MINIMUM QUALIFICATION REQUIREMENTS Education - Registered Nurse (RN) credentials required. - Master’s or bachelor’s Degree strongly preferred. Experience - Minimum 6+ years’ experience in apheresis, blood product management, blood transfusion or blood banking. - Apheresis technology experience is strongly preferred. - Previous experience with genetic hematological disorders such as sickle cell disease will be a plus. Skills - Strong interpersonal, influencing, and negotiation skills with different types of internal and external stakeholders. - Team player, patient and customer-focused, problem solver with clear focus on end-results. - Ability to work autonomously and independently with time management skills to effectively manage field-based responsibilities. - Ability to work in a matrix structure, i.e. maintains strong working relationships with various other departments, such as Scientific & Clinical Affairs, Regulatory Affairs, Legal, Global & Regional Marketing and Sales. - Able to build trust and credibility with healthcare professionals, internal experts, and cross‑functional partners. - Excellent in written and oral communication skills in English. Any additional language will be a plus. Certificates, Licenses, Registrations - Registered Nurse (RN) credentials required. - Certification in Apheresis or other professional credentials and/or certifications preferred. -Or- An equivalent competency level acquired through a variation of these qualifications may be considered. LOCATION Lakewood, Colorado or Remote TRAVEL Domestic travel required up to 20-30%. PHYSICAL REQUIREMENTS - Typical Office Environment requirements include: reading, speaking, hearing, close vision, walking, bending, sitting, and occasional lifting up to 20 pounds. - The physical demands described here are representative of those that must be met by an associate to successfully perform the essential duties of this job. - Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties. Target Pay Range: $120,600.00 to $150,800.00 - Salary to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data Target Bonus on Base: 10.0% At Terumo Blood and Cell Technologies, we provide competitive total reward offerings that consist of compensation, benefits, recognition, along with a wealth of other well-being, work-life and recognition programs which support in unlocking the potential for you and your family. Included in our expansive list of benefits offerings are multiple group medical, dental and vision plans, a robust wellness program, life insurance and disability coverages, also a variety of voluntary programs such as group accident, hospital indemnity, critical illness, pet insurance and much more. To help you save for retirement, we offer a 401(k) plan with a matching contribution and for work-life balance we have vacation and sick time programs for associates. For us, it’s about protecting the personal welfare of our associates and their families, helping to achieve personal goals and offering those extra touches for convenience, security and overall peace of mind. - Terumo Blood and Cell Technologies is part of Terumo Group, founded in 1921 and headquartered in Tokyo, Japan. - In 2024, Terumo Blood and Cell Technologies reached $1.5 billion in revenue. - We employ nearly 8,000 associates globally, with global headquarters in Lakewood, CO, U.S., and regional headquarters in Brussels, Buenos Aires, Singapore and Tokyo. - We manufacture devices, disposable sets and solutions at our facilities in Belgium, India, Japan, Northern Ireland, the U.S. and Vietnam. Our global presence enables us to serve customers in more than 130 countries. - Our core values help set our direction, guide our actions and keep us true to our corporate mission of contributing to society through healthcare. - Respect – Appreciative of others - Integrity – Guided by our mission - Care – Empathetic to patients - Quality – Committed to excellence - Creativity – Striving for innovation - We contribute to the Leukemia and Lymphoma Society (LLS), raising $2.4 million USD since 2025. We are proud to be an Equal Opportunity Affirmative Action Employer. All applicants will be afforded equal opportunity without discrimination because of race, color, religion, sex, gender identity or expression, sexual orientation, marital status, order of protection status, national origin or ancestry, citizenship status, age, physical or mental disability unrelated to ability, military status or an unfavorable discharge from military service. Terumo Blood and Cell Technologies is committed to providing a safe, healthy and secure working environment. Our Colorado campus locations are tobacco-free workplaces, and we maintain a drug-free workplace and perform pre-employment substance abuse testing and detailed background verification.