Managed Care Resources MCR Jobs in Santa Ana

Currently, there are no Managed Care Resources MCR jobs available in Santa Ana, 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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Successful niche Healthcare Recruiting firm in West Los Angeles is looking for a motivated individual to be an Office Administrator. A degree from an accredited college or university at the Bachelors level is preferred but not required. We are looking for someone who has an outgoing personality, understands what good customer service is, has the ability to listen and follow directives with littl...
Successful niche staffing firm in West Los Angeles looking for a recruiter to run it's very lucrative well established contract staffing desk. This position involves inside business to business sales and development, recruiting, social media research, interviewing and sound decision making skill. Managed Care Resources has been serving the State of California for over 28 years. We have a very rep...
Nurse 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 organi...
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 ...
Ambulatory Case Manager (Outpatient)– 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 addres...
Prior Authorization (Referral) Nurse Case Manager (RN or LVN) 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 Submi...
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...

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