Managed Care Resources MCR Jobs in Garden Grove

Currently, there are no Managed Care Resources MCR jobs available in Garden Grove, 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.
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Description: Prestigious acute care hospital in San Diego - in search of a qualified RN Charge Nurse in the ICU Department Direct supervision of ICU staff - will assist the Director in directing, supervising, and evaluating staff and performance Works closely with the ICU Director If need be, perform direct patient care Continually assess care provided and make changes in the care plan if nec...

Quality Control Specialist Performs retrospective audits identifying overpayments, underpayments and system configuration issues. Audits daily professional and facility claims for assigned groups. Flags claims for examiner errors. Maintains a solid working knowledge of Healthplan and provider contracts, division of responsibility (DOFR), and CPT/ICD9 coding. Excellent knowledge of CPT, RBRVS,...

Hospital - RN Case Manager 40 Hours per week, full time Fast paced hospital environment Chart reviews and quality assessments using severity of illness (SI) and intensity of service (IS) InterQual criteria (and/or Milliman) Level of Care, Length of Stay, Continued Stay Reviews Coordinating discharge planning with physicians, nursing, and social services, patient and family. REQUIREMENTS Act...

Registered Nurse-Licensed Vocational Nurse Home Health Intake Processing mew orders and sending out to Field Case Managers Prior Home Health Intake experience Full time 40 hours per week (5 days per week, 8 hour shifts) Office Desk job Valid California Registered Nurse or Licensed Vocational Nursing License Good phone and computer skill necessary Fast paced environment Hit the ground runni...

LVN Inpatient Case Manager Full time 40 hours per week (estimated 2-3 months) Possibly longer assignment or other Temp to Perm Track available Prior Case Management Experience Health Plan, Office Desk Job Mon.-Fri.; 40 Hours per Week; 8 hour per day Adequate transportation to travel between facilities required Valid California Licensed Vocational Nursing License One (1) year Case Managemen...

The OB Director will manage the administrative responsibilities for all obstetrical nursing functions Will ensure the delivery of quality patient care trough planning, assessing, implementing, and supervising Instrumental in developing and implementing departmental plans, including performance improvement activities Will maintain quality care through compliance with local, state, and federal re...

Claims Auditor / Quality Control Analyst Managed Care (Office) Audits claims to identify examiner and system errors. Research and resolve. Audits daily professional and facility claims Flags claims for examiner errors. Reviews daily audit reports and takes appropriate actions. 2+ years experience in professional and institutional claims examining and/or auditing. Excellent knowledge of CPT,...

Registered Nurse - Case Manager Our client, an extremely reputable client in the greater Los Angeles area, is currently looking for a Hospital Case Manager to fill an immediate need. This is a long term (or temp to perm for right candidate) position for those interested. Successful Registered Nurse Case Manager candidates will need to have at least two (2) years of working in an acute setting wi...

Quality Control Specialist Performs retrospective audits identifying overpayments, underpayments and system configuration issues. Audits daily professional and facility claims for assigned groups. Flags claims for examiner errors. Maintains a solid working knowledge of Healthplan and provider contracts, division of responsibility (DOFR), and CPT/ICD9 coding. Excellent knowledge of CPT, RBRVS,...

Description: The Registered Nurse will be responsible for quality care given to assigned patients. Will communicate with physicians about changes in patients condition, including, hemodynamic monitoring, results of diagnostic studies and abnormal results and symptomatology Must have the ability to adapt quickly and effectively to changes in patient's clinical condition and make sound judgments ...

Looking for a RN / LVN to Write Patient Care Plans Registered or Licensed Vocational Nurse to work for a local medical group Completing back logs of Care Plans for new system Must have exemplary writing skills with writing patient Care Plans Familiarized with Microsoft Office, Excel, Outlook, and Webmail Keywords: Case Manager Impatient Utilization Review Utilization Management Discharge Pla...

LVN Inpatient Case Manager Full time 40 hours per week (estimated 2-3 months) Possibly longer assignment or other Temp to Perm Track available Prior Case Management Experience Health Plan, Office Desk Job Mon.-Fri.; 40 Hours per Week; 8 hour per day Adequate transportation to travel between facilities required Valid California Licensed Vocational Nursing License One (1) year Case Managemen...

Prestigious acute care hospital is in need of an ICU Manager. This position reports directly to the ICU Director and will work alongside him/her to ensure the highest delivery of quality and cost-effective care. · ICU Manager · Five years of clinical/hospital experience – preferably in the ICU · Valid CA RN License · Salary: $80,000 - $110,000 depending on experience · (The ideal candidate wi...

We have an urgent need for a Director of Case Management. This position is full time and offers outstanding benefits. One of Los Angeles' most prestigious Hospitals is in need of a talented RN with extensive clinical Case Management experience. Looking for: A highly motivated and energetic individual Someone capable of leading a successful team Experience in a managed care setting, supervisin...

Looking for a RN / LVN to Write Patient Care Plans Registered or Licensed Vocational Nurse to work for a local medical group Completing back logs of Care Plans for new system Must have exemplary communication skills and previous experience writing patient Care Plans Familiarized with Microsoft Office, Excel, Outlook, and Webmail...

Director of Occupational Therapy - Large Hospital network The Director of Occupational Therapy will be responsible for managing a high performing staff and providing the highest level of occupational therapy services Will work with various levels of healthcare team members Coordinate and ensure educational in-services for staff Perform various therapy functions and may administer medication R...