Managed Care Resources MCR Jobs in Cupertino

Currently, there are no Managed Care Resources MCR jobs available in Cupertino, California. You may wish to explore jobs in nearby locations on the Managed Care Resources MCR jobs in California page or view related jobs below.
Here are some related jobs:
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 ...
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...
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 ...
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 ...
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...
Ambulatory Case Manager – Office Setting Duties: 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 me...
Case Manager, Inpatient (Concurrent Review) Monday - Friday; 8/hr/day About the Job: Utilization Review, Concurrent Review, Discharge Planning, Transfers Level of Care and length of stay reviews (SI / IS) Reviews, verifies and processes requests for referrals, inpatient and outpatient procedures, home health services, DME Strong problem solving and organizational skills Knowledgeable of: D...
Nurse Case Manager (Registered Nurse) Mon.-Fri. 40 hours per week Duties: 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 ...
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...
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...
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...
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...
Ensuring the quality of credentialing files of contracted providers in accordance with NCQA and DHS guidelines. Responsible for maintaining internal quality standards, supporting the Credentialing Committee program and coordinating Health plan activities. About the Job: Processes credentialing/re-credentialing files for committee review (NCQA/state regulatory requirements) Ensures that provide...
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 Submit treatment authorization requests to health plans as needed D...

Didn't find the right job at Managed Care Resources MCR in Cupertino, California?
We'll keep looking and send you new jobs that match this search.
email me

Upload your resume and let employers find you!
It's that simple!

Popular Articles

Best-Paying Work-from-Home Jobs Article Rating
It’s easier than ever to work from home. Of course, not every job is a mobile job, and some companies aren’t interested in having their employees work from home.
2013 Marketing Jobs Outlook Article Rating
The US may be facing another year of anemic hiring overall, but that won't be the case in the high-orbit world of multichannel, digital media marketing.
For Employers: Post Jobs | Search Resumes | Advertise
About Monster | Work for Monster | Advertise with Us | AdChoices | Partner with Us | Investor Relations | Social Media
Terms of Use | Privacy Center | Accessibility Center | Help | Security | Contact Us | Sitemap | Mobile
©2014 Monster - All Rights Reserved U.S. Patents No. 5,832,497; 7,599,930 B1; 7,827,125 and 7,836,060 MWW - Looking for Monster Cable? - V: 2014.4.50.56-221
eTrustLogo