San Jose
Managed Care Resources MCR Jobs in San Jose
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RN Case Manager Inpatient Concurrent Review Monday - Friday; 40 hours per week __________________________________________ Milliman or InterQual intensity of service, severity of illness or similar utilization management tools Length of stay, continued stay review, authorization of services based upon evidence based criteria Coordination of inpatient admissions, management of entire stay with healt...
Hospital, Inpatient RN Case Manager / Care Coordinator Full Time - 40 Hours Per Week; 8 Hours per day The Job: Concurrent Review Utilization Review Discharge Planning Authorizations (TARS) Case Management from Admission to Discharge Ability to: Provide concurrent review and analysis of inpatient records to determine if the patient's admission and continued acute stay flags any quality indicators....
Nurse (LVN) 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 organiz...
This acute care hospital is looking for a Nurse who combines solid leadership with great clinical skills. A "role up your sleeves" type position, this is a great match for someone who wants to further their career without giving up their passion for floor work and patient care. The Clinical Manager will report to the Director of Telemetry/Med-Surg. This is a full time, permanent position with full...
An excellent, medium sized acute hospital is looking for a Director to lead their Maternal Services department. Reporting to the CNO, the chosen candidate will be responsible for managing staff, implementing and maintaining department programs, and driving the service line for the hospital. Requirements California RN Bachelor's in nursing 3+ years management experience in Maternal Health 5+ years...
This is a once-in-a-lifetime opportunity to join one of the best hospital systems in Southern California as they open a brand new acute care facility. Along with support from the CEO, you will grow the case management department from the grand-up, implement programs as you see fit, and design the entire department as you see fit as long as it aligns with the hospitals' Mission and Goals. As such,...
RN Case Manager - Inpatient Monday- Friday; 40 Hours a Week The Job: Manage a caseload of patients by (re)assessing the individual's needs made by the PCP/Specialist. Level of care, length of stay, continued stay review. SI/IS. Discharge planning for transition of care planning Reviews, verifies and processes requests for referrals/authorizations of services. Strong problem solving and organizat...
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 Rev...
An excellent acute care facility in south Riverside County is looking for a Director to head up their Women's Services department. While the hospital itself is not large (150 beds), it is part of one of the premier management companies in Southern California, combining the intimacy of a small facility with the stability of a larger one. The chosen individual will work closely with the CNO, and ass...
As a manager, you've already had a successful career. You've worked your way up through the nursing ladder, always honing your clinical skills and striving for quality care. Now you're a leader, and are showing others how to follow in your footsteps. That's why we want you. The hospice organization we're representing is established. They have multiple sites across Southern California, and have gar...
Hospital - 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. Coordinate chart reviews for quality reports and clinical procedures Manage cases smoothly and increase patient/physician satisfaction. Track out...
Proven ability to read and interpret medical record data for chart audits or abstractions Ability to track patients and generate reports for CMS and Administration Strong Auditing Skills, ICD-9 Coding Microsoft applications: Outlook, Word, Excel Ability to navigate a database Excellent written and oral communication skills Excellent organizational and multi-tasking skills Knowledgeable of: Title 2...
Hospital, Inpatient RN Case Manager Full Time - 40 Hours Per Week About the Job: Concurrent Review Utilization Review Discharge Planning Authorizations (TARS) Case Management from Admission to Discharge Requirements: California Nursing License (RN) 2+ Years of Inpatient Case Management Experience InterQual and/or Milliman criteria experience a plus Knowledge of: DRG and ICD-9 and CPT coding, requi...
As a manager, you've already had a successful career. You've worked your way up through the nursing ladder, always honing your clinical skills and striving for quality care. Now you're a leader, and are showing others how to follow in your footsteps. That's why we want you. The hospice organization we're representing is established. They have multiple sites across Southern California, and have gar...
Healthcare is changing rapidly, and as a member of this organization you will not be left behind. Quality of patient care and census growth of of course important, but this company has its eyes on the bigger picture. Integrating multiple layers of care into a continuum of care model should position this organization at the forefront of palliative care. As a Team Leader, you and three other colleag...
We're looking for a leader. Someone who wants to come to work everyday because they love the people they work with and the service they provide. One of the best hospices in Southern California is looking for the best Team Leader they've ever hired to come on-board. Overseeing a team of nurses in the South LA area, you will be responsible for the oversight and direction of your staff, ensuring the...
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©2013 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: 2013.1.5.22-320