Managed Care Resources MCR Jobs & Careers

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15 Managed Care Resources MCR jobs found on Monster.

Jobs 1 to 15 of 15
Managed Care Resources (MCR) Ontario, CA
Ambulatory Case Manager (Outpatient)– Registered Nurse (RN) or LVN Responsible for the care management (coordination of outpatient care) of members with catastrophic illnesses and the chronically ill while ensuring that quality standards are met by using clinical judgment to evaluate and assess. Apply case management concepts, principles, and strategies to develop a Plan of Care (Care Plan) that...
Managed Care Resources (MCR) Riverside, CA
Concurrent Review Nurse (LVN or RN) – Medical Office, Desk Job Job Descriptions as follows: Coordination of inpatient admissions, management of entire stay with IPA and health care team. Coordinate directly with the department of inpatient admissions, discharges and transfers as appropriate. Facilitation of movement of the patient through the continuum of care ascertaining the next appropriate...
Managed Care Resources (MCR) Fontana, CA
Prior Authorization (Referral) Nurse Case Manager (RN or LVN) Review referral requests (routine, urgent & stat) for various office visits, outpatient and inpatient procedures using Milliman Care Guidelines to determine medical necessity Coordinate reviews, deferrals & denials with medical director, medical groups, health plans Create denial letters based on the MD's review and guidelines Submi...
Managed Care Resources (MCR) Long Beach, CA
Ambulatory Case Manager – Registered Nurse (RN) LVN Responsible for the care management (coordination of outpatient care) of members with catastrophic illnesses and the chronically ill while ensuring that quality standards are met by using clinical judgment to evaluate and assess. Apply case management concepts, principles, and strategies to develop a Plan of Care (Care Plan) that addresses the ...
Managed Care Resources (MCR) Tarzana, CA
Nurse Case Manager Monday - Friday; 8/hr/day Medical Management Office About the Job: Manages a caseload of patients by assessing the individual's needs made by the PCP/​Specialist.​ Utilization Review, Concurrent Review, Discharge Planning Reviews, verifies and processes requests for referrals, inpatient and outpatient procedures, home health services, DME Strong problem solving and organi...
Managed Care Resources (MCR) Los Angeles, CA
Job Duties and Essential Functions: Read and be familiar with the Employee Handbook and comply with all company policies and procedures. Design and implement quality initiatives designed to improve performance for referrals production and timeliness, to include daily quality reviews. Establish and facilitate routine communication and feedback mechanisms for quality findings to the referral and ...
Managed Care Resources (MCR) Fountain Valley, CA
Ambulatory Case Manager – Registered Nurse (RN) Responsible for the care management (coordination of outpatient care) of members with catastrophic illnesses and the chronically ill while ensuring that quality standards are met by using clinical judgment to evaluate and assess. Apply case management concepts, principles, and strategies to develop a Plan of Care (Care Plan) that addresses the memb...
Managed Care Resources (MCR) Woodland Hills, CA
This is a position that focuses on utilization review including assessment of medical records for appropriateness, level of care provided. You will assess utilization of treatment, modalities, medications, services and application of treatment protocols. A team approach with other members of internal staff is important. Requirements: California Nurses license, Registered Nurse (RN) Utilization ...
Managed Care Resources (MCR) Cypress, CA
This is a position that focuses on utilization review including assessment of medical records for appropriateness, level of care provided. You will assess utilization of treatment, modalities, medications, services and application of treatment protocols. A team approach with other members of internal staff is important. Requirements: California Nurses license, Registered Nurse (RN) Utilization ...
Managed Care Resources (MCR) Long Beach, CA
The Patient Care Coordinator provides office and referral management support services and assists the Case Managers in obtaining medical records, documenting all case information in the system, performing data entry into appropriate databases for monitoring and tracking, and following up on phone calls as directed by the Case Managers. The Patient Care Coordinator serves as a contact between memb...
Managed Care Resources (MCR) Torrance, CA
Our client is looking for an RN who will work Home Health and Hospice doing office and/or field Case Management. This is not a clinical position but a position where you are consulting with family, doctors, patients and nurses to refer for the right level of care or the next step in comforting the patient and families. You must have Hospice or Home Health Case Management experience. Palliative ex...
Managed Care Resources (MCR) Gardena, CA
Registered Nurse (RN) - Quality Improvement (QI) - Home Health, Hospice Major Home Health, Hospice Department Quality Nurse (QI, QA, QM) Must have at least 3+ Years experience in Quality Home Health 40 Hours a Week About the Job: Participates in development and implementation of Quality Improvement programs To review health procedures and statistics. To determine and document any areas tha...
Managed Care Resources (MCR) Torrance, CA
Intake Coordinator - Home Care - Registered Nurse (RN) About the Job: Home Care Intake Coordinator (Office Desk job) Processing new orders and sending to Field Case Manager for follow up Responsible for ICD-9 coding Plan of care proofreading (OASIS) 485 correction Responsible for Chart Audits, Documentation of Medical Necessity Home Health, Hospice, Palliative Care Requirements California...
Managed Care Resources (MCR) Encino, CA
RN Registered Nurse, Case Manager SNF Placements 8/hr/day at 40/hr/week ___________________________________ This nurse will work with the skilled nursing facilities, Inpatient Case Managers, SNF Case Managers; placing patients from the Hospital into the local skilled nursing facilities (SNFs) Must have 3+ years experience. About the Agency: Managed Care Resources, Making Careers is a Health...
Managed Care Resources (MCR) Los Angeles, CA
Case Manager Registered Nurse (RN) Full Time, 40 Hours Per Week About the Job: Concurrent review and analysis of inpatient records to determine if the patient's admission and continued hospital stay triggers any pre-defined quality indicators. Utilization review including assessment of medical records for appropriateness, level of care provided. Assess utilization of treatment, modalities, m...

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