Utilization Review Coordinator

**Facility Overview** At Ocean View Psychiatric Health Facility, we are committed to serving as a community resource, providing the highest quality of mental health services. Currently, Ocean View operates as an adult 39-bed voluntary acute in-patient facility, offering private rooms and individualized care through a multi-disciplinary approach focusing on...

For this position we are seeking a California (RN) Registered Nurse with 3 years+ Concurrent Review/ Utilization Review / Utilization Management and must have Interqual, and MCG guidelines experience. CURRENT RN CALIFORNIA LICENSURE IS REQUIRED FOR THIS POSITION. California is not a compact state at this time. This department operates 365 days a year and we...

For this position we are seeking a California (RN) Registered Nurse with 3 years+ Concurrent Review/ Utilization Review / Utilization Management and must have Interqual, and MCG guidelines experience. CURRENT RN CALIFORNIA LICENSURE IS REQUIRED FOR THIS POSITION. California is not a compact state at this time. This department operates 365 days a year and we...

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior...

Job Description: Position is fully remote and will be a temp role through 3/31/23. Position has the option to go perm based on positive work. Candidates can sit anywhere in the US and schedule will be M-F 9AM-5PM local time. The training schedule will be M-F 9AM-5PM EST. Daily responsibilities will include the following: Candidates will be reviewing medical...

Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired...

Job DescriptionJOB DESCRIPTIONJob Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients...

Coordinates the maintenance, repair, modification, replacement and calibration of pneumatic, hydraulic, magnetic and electronic instrument transmitters, receivers, totalizers, recorders and complex controls used in water/wastewater treatment and pump stations. Oversees communication with computer interface in all the utility installations; applies...

Job DescriptionJOB DESCRIPTIONJob Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding...

**_Care Review Processor with Managed Care Exp. (Remote - PST)_** - able to work late hours AND weekends.**Position Summary**: Works within the Care Access and Monitoring (CAM) team to provide clerical and data entry support for Molina Members who require hospitalization and/or utilization review for other healthcare services. Checks eligibility and verifies...

**Position: Utilities Compliance Coordinator** **Reports to: Operations & Compliance Director** **Emergency Classification: Essential** **FLSA Classification: Non-Exempt** **Pay Grade: 108** **Town of FMB Offers a Competitive Benefit Package!** **Health & Wellness**:Comprehensive health insurance plans for you and your family with low deductibles and...

Overview CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our...

**JOB DESCRIPTION****Job Summary**Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients...

**JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients...

Description Title: Medical Staff Coordinator Location: Long Beach, CA Department: Medical Staff Status: Full-Time Shift: Days (8hr) Pay Range*: $33.11/hr - $48.04/hr At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care...

Do you have a passion for helping the underserved in your community? Are you a team player with a good attitude ready to step into a challenging position? Do you have impeccable communication and organization skills to contribute to an amazing team? If you are an experienced IT Support Analyst and you answered yes to these questions, then TCC Family Health...

Purpose The purpose of this classification, under administrative direction, is to apply recognized engineering standards for review of proposed and current development projects within the City. Performs highly responsible administrative work in the enforcement of the Flood Plain Management Program and Land Development Code for the purpose of ensuring...

Position Description Seeking a full-time Program Coordinator to join Tarzana Treatment Centers’ Opioid Treatment Program (OTP). Working in a fast-paced environment, incumbent will be a part of a multidisciplinary team including peer-support specialists, nurses, and medical providers working directly with OTP patients providing individual and group...

Job DescriptionJob DescriptionSalary: $21/hr. W2Care Review Processor with Managed Care Exp. (Remote – PST) We are looking to hire a candidate with the experience and skill sets mentioned for one of our major clients within the Health Insurance industry. This is a 3-month contract opportunity with the potential for extension (s). This is...

Job DescriptionJob DescriptionPosition Title: Program CoordinatorDepartment: Recovery Support Reports To: Program DirectorPOSITION SUMMARYResponsible for overall day-to-day supervision of assigned staff and the shift-to-shift or day to day operations of program or unit. This includes oversight of patient activities and staff responsibilities as they relate...