Managed Care Resources MCR Jobs & Careers

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13 Managed Care Resources MCR jobs found on Monster.

Jobs 1 to 13 of 13
Managed Care Resources (MCR) Garden Grove, 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 Rev...
Managed Care Resources (MCR) Sherman Oaks, CA
Nurse Case/Care Manager - Telephonic, Desk Job About the Job: · Care Coordination · Reviews, verifies and processes requests for referrals/authorizations of services. · Strong problem solving and organizational skills in a fast paced environment. · Coordination of care and quality of care. Knowledgeable of: · Effective charting practices and guidelines. · Principles and practices of health care, h...
Managed Care Resources (MCR) Cypress, 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, medicat...
Managed Care Resources (MCR) Canoga Park, CA
The Medical Authorization Nurse, LVN provides office and referral management support services 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 Serves as a contact between members, physicians, providers, and staff, processing the initial intake of information, a...
Company Confidential Irvine, CA
Client in Orange County looking for experienced Executive Director for financially successful and growing hospice home care organization in Orange County covering both Orange and Los Angeles Counties. Successful candidates will oversee the functions of the company operational systems. The will also develop and expand revenue performances and business potential of the hospice and oversee the qualit...
Company Cinfidential Anaheim, CA
Growing successful hospice home care company is looking for a Director of Patient Care Services. This person will act on behalf of the Administrator in their absence. Leader of the patient care team. Supervise and evaluate as well as coordinate the various component of members of the interdisciplinary teams while assuring continuity of care. Successful candidates will: Direct all patient care serv...
Managed Care Resources (MCR) Westminster, CA
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 Plan)...
Managed Care Resources (MCR) Sherman Oaks, CA
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...
Managed Care Resources (MCR) Tarzana, CA
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 Deter...
Managed Care Resources (MCR) Beverly Hills, CA
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: DRG and I...
Managed Care Resources (MCR) Los Angeles, CA
RN Case Manager - Medical Center About the Job: Responsible for assessing, planning, implementing, and evaluating the needs of patients for discharge planning and utilization review. Level of Care, Length of Stay, Continued Stay Reviews Coordinate utilization management, care facilitation, and discharge planning Coordinate discharge planning with physicians, nursing, and social services, patient a...
Managed Care Resources (MCR) Long Beach, CA
Hospital, Inpatient RN Case Manager / Care Coordinator The Job: Concurrent Review Utilization Review Discharge Planning Authorizations (TARS) Case Management from Admission to Discharge Ability to: Responsible for assessing, planning, implementing, and evaluating the needs of patients for discharge planning and utilization review. Level of Care, Length of Stay, Continued Stay Reviews Coordinate ut...
Managed Care Resources (MCR) Los Angeles, CA
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 membe...

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