Managed Care Resources MCR Jobs in California

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15 Managed Care Resources MCR jobs in California found on Monster.

Jobs 1 to 15 of 15
The Quality Control Analyst audits claims to identify examiner and system errors. Maintains a solid working knowledge of Health plan and provider contracts, division of responsibility (DOFR), and CPT/ICD9 coding. Audits daily professional and facility claims for assigned groups. Flags claims for examiner errors. Applies McKesson Claim Check software daily report edits to flag claims for correc...
Licensed Nurse Practitioner 1 month assignment for a very renown healthcare organization in the Los Angeles area. Prior Experience a must Passionate about patient care Contact for more information...
The Behavioral Health Director will provide leadership direction and ensure that all practices are in compliance with Local, State, and Federal rules and guidelines. The BH Director will ensure that best practices are always striving to be achieved in Behavioral Health and Disease Management in-order to keep the organization abreast of quality improvement efforts. Ability to converse and build s...
Hospital - RN Inpatient Case Manager · Responsible for the assessment, facilitation, planning and coordination of medical care and services for patients to ensure appropriate treatment in the most cost effective manner · Level of Care, Length of Stay, Continued Stay Reviews · Coordinating discharge planning with physicians, nursing, and social services, patient and family. · Review patient pro...
Registered Nurse (RN) - Case Manager - Managed Care and Hospital Positions Available 1. Responsible for assessing, planning, implementing, and evaluating the needs of patients for discharge planning and utilization review. 2. Responsible for the assessment, facilitation, planning and coordination of medical care and services for patients to ensure appropriate treatment in the most cost effectiv...
If you are tired with your current employer, commute, or current living situation and would like to pursue something much better and more exciting, give me a call. - Large, financially secure Medical Provider is looking for a qualified In-patient Case Manager - Competitive Salary with full benefits and excellent bonus structure - West Los Angeles - Minimum of one year clinical experience - LV...
Inpatient Hospital Registered Nurse (RN) Case Manager Actively monitors and manages the utilization of healthcare resources for each member along the care continuum, and ensures that the optimum quality of care is provided Identify cases with the potential for high risk complications while acting as an advocate for the patient's healthcare needs Coordination of care with physicians, staff, pati...
The Inpatient Case Manager actively monitors and manages the utilization of healthcare resources for each member along the care continuum, and ensures that the optimum quality of care is provided Identify cases with the potential for high risk complications while acting as an advocate for the patient's healthcare needs Assumes a leadership role through the coordination of care with physicians, s...
Audits claims to identify examiner and system errors. Research and resolve. Maintains a solid working knowledge of Health plan and provider contracts, division of responsibility and coding. Reviews daily audit reports and takes appropriate actions. Identifies any inappropriate provider billing issues. Maintain proper accounting records, back up and reports. 2+ years experience in professional...
Home Care Intake Nurse (RN) (Desk Job) 1. Active RN California License 2. Temp (Contract) Long Term On-going 3. 40 hours per week (5 days per week, 8 hours shifts) 4. Processing new orders and sending out to Field Case Managers 5. Strong computer skills, quick study 6. Prior experience...
The Inpatient Case Manager actively monitors and manages the utilization of healthcare resources for each member along the care continuum, and ensures that the optimum quality of care is provided Identify cases with the potential for high risk complications while acting as an advocate for the patient's healthcare needs Assumes a leadership role through the coordination of care with physicians, s...
About the Job: Manager, Case Management - Medium sized, acute care hospital - Los Angeles Medium sized hospital in Los Angeles is seeking a Manager of Case Management. This individual will be responsible for providing leadership to the CM department. Will maintain compliance with State and Federal rules and regulations and ensure that the hospital is within standards at all times. Responsible fo...
Urgent need for a Registered Nurse Case Manager Prior experience in Inpatient Hospital Case Management Active RN License in the State of California 40 Hours per Week and/or Weekend Work available Available to start ASAP Please contact if interested...
Hospital - Registered Nurse Case Manager - 40 Hours Per Week · Responsible for the assessment, facilitation, planning and coordination of medical care and services for patients to ensure appropriate treatment in the most cost effective manner · Level of Care, Length of Stay, Continued Stay Reviews · Coordinating discharge planning with physicians, nursing, and social services, patient and famil...
Looking for an experienced LVN / RN Case Manager with experience serving the Infectious Disease, complex disease population's. Must have prior case management experience. A Valid RN or LVN California nursing License This job is 40 hours per week. Office / Desk job responsibility only (no field work) Los Angeles area...

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