Utilization Review Nurse Salary at New Century Health BETA

Job Description Job Description ESSENTIAL DUTIES AND RESPONSIBILITIES: Responsible for implementing and managing the Adult Day Health Care Program/CBAS, ensuring compliance with all federal, state and local regulatory requirements. Plan, implement set target, and goals for program according to the strategic objectives of the organization Maintains required records and reports in compliance with department, agency, local, state and federal requirements. Responsible for hiring and training employees and maintaining required personnel and certification records for employees. Selects, assigns, directs, and evaluates the performance of department staff. Supervises ADHC staff, volunteers and contract consultants. Provides regular staff meetings, assignments and scheduling. Develops the center programs in accordance with the needs of the participants and community served. Continuously evaluates the participants’ changing needs and makes necessary program adjustments. Apply change, risk and re

NATIONAL LEADERS IN PEDIATRIC CARE Ranked among the top 10 pediatric hospitals in the nation, Children's Hospital Los Angeles (CHLA) provides the best care for kids in California. Here world-class experts in medicine, education and research work together to deliver family-centered care half a million times each year. From primary to complex critical care, more than 350 programs and services are offered, each one specially designed for children. The CHLA of the future is brighter than can be imagined. Investments in technology, research and innovation will create care that is personal, convenient and empowering. Our scientists will work with clinical experts to take laboratory discoveries and create treatments that are a perfect match for every patient. And together, CHLA team members will turn health care into health transformation. Join a hospital where the work you do will matter-to you, to your colleagues, and above all, to our patients and families. The work will be challenging, bu

Classification/Title: LICENSED VOCATIONAL NURSE / PSYCHIATRIC TECHNICIAN Work Location: Orange County Work Hours: AMs 6am-2pm PMs 2pm-10pm Nocs 10 pm-6am GENERAL STATEMENT OF DUTIES: Follows established standards and procedures, provides supervision, care, support, and training to individuals with Developmental Disabilities, in a home setting. Assist individual with dining, toileting skills, grooming, and appearance. Analyze situations accurately, take effective action; follow directions and communicate effectively in English. Have knowledge of state and federal laws, Regional Centers, Department of Social Services, Department of Developmental Services, and State Council on Developmental Disabilities. Have knowledge of Title 17 and 22. Have knowledge of dual diagnosis, Individual Program Plans, residents' service needs, emergency disaster protocol and behavior plans. May be asked to work extended hours and/or varying shifts. Responsible for attending training and participate in Contine

Job Description Job Description Kinetic Personnel Group is currently recruiting a Medical Case Manager (RN) for a $3 billion-dollar a year government public health plan (government agency) is renowned for its work in the community and being a great place to work. Case Management is an advanced specialty collaborative practice, responsible for providing ongoing case management services for health plan Direct members. The Medical Case Manager will facilitate communication and coordination amongst all participants of the health care team and the members to ensure that the services are provided to promote quality, cost-effective outcomes. The incumbent provides case management intervention on behalf of members with short term, stable, and predictable courses of illnesses. The incumbent is also responsible for answering the medical appropriateness, quality, and cost effectiveness of proposed hospital/medical/surgical services in accordance with established criteria. This activity may be con

Responsibilities Come and join the RMC Family! We have been in the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare. Riverside Medical Clinic is the best place to work, practice medicine, and receive care. SUMMARY: Responsible for the processes of evaluating the necessity, appropriateness, and efficiency of outpatient/ambulatory services per health plan and regulatory standards. Assists the Manager of Medical Management and/or the Regional Director of Quality Risk & Utilization Management in preparing required documentation for Health Plan audits and appeals. This role entails overseeing

Current Emanate Health Employees - Please log into your Workday account to apply Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as individuals. On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country. Job Summary The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying clinical acumen and the appropriate application of policies and guidelines to urgent and standard reviews. You will document decisions using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and level of care reviews for requested servi

Overview: UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among Americas Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange Countys only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles Co

Description The Licensed Vocational Nurse Clinic Supervisor's main responsibilities are to lead the clinic team with outstanding patient care, assist medical providers in clerical duties as defined in the Licensed Vocational Nurse Scope of Practice, and ensure streamlined, efficient, and compliant front/back office process and workflow. The LVN Clinic Supervisor will work collaboratively with the Nursing director and report to the Clinic Manager. The best candidate for this position: holds a Licensed Vocational Nurse license, current and in good standing has previous successful experience supervising both back and front office staff in a medical/clinic setting has an understanding of medical clinic office workflow and processes is bilingual in Spanish, including medical terminology What You'll Do: Job Responsibilities & Duties 1. Directs, coordinates, and facilitates the daily work of a primary care team. 2. Ensures that the team's Direct Patient Care, Office and Administrative Duties