Managed Care Resources MCR Jobs & Careers

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12 Managed Care Resources MCR jobs found on Monster.

Jobs 1 to 12 of 12
Managed Care Resources (MCR) los angeles, CA
Job Description: The NICU Clinical Manager works in collaboration with the Associate Administrator to develop, implement, coordinate, and evaluate the delivery of nursing care services. This position is also responsible for ensuring the delivery of quality nursing care to patients and their families. Primary duties include but are not limited to: interviewing and screening candidates for hire, ...
Managed Care Resources (MCR) Long Beach, 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...
Managed Care Resources (MCR) Los Angeles, 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 ...
Managed Care Resources (MCR) Cypress, CA
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...
Managed Care Resources (MCR) Encino, CA
Ambulatory Case Manager – Office Setting Telephonic Desk Job 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) t...
Managed Care Resources (MCR) West 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: D...
Managed Care Resources (MCR) Tarzana, CA
Ambulatory Case Manager (Outpatient)– Registered Nurse (RN) or LVN 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...
Managed Care Resources (MCR) Los Angeles, CA
Home Health / Hospice Medical Offices (South Bay area) 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 org...
Managed Care Resources (MCR) West Los Angeles, CA
About the job: We're looking for an innovative Manager with excellent communications skills, foresight, and a passion for educating and mentoring others. The Manager of Ambulatory/Outpatient Care Management will plan, organize, implement, and direct care coordination activities. Responsible for providing oversight and broad direction to case management, which includes care coordination, utilizati...
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. Tr...
Managed Care Resources (MCR) Simi Valley, CA
The Discharge Planner, in conjunction with other members of the health care team is accountable for timely coordination of quality health care services to meet the patient's health care needs across the continuum of care. This position requires knowledge of the development stages as services are provided to infants, children, adolescent, pediatrics, adult and geriatric populations. The Discharge P...
Managed Care Resources (MCR) Canoga Park, CA
Prior Authorization (Referral) Nurse Case Manager (RN) 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 treat...

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