Prior Authorization Registered LVN
7 days ago
Vivo HealthStaff is hiring a Prior Authorization LVN for a health plan based in Southern California.
Position Details:
Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to prior authorization requests.
- Perform telephonic review of prior authorization requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations
- Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings
- Collaborate with various staff within provider networks and case management team electronically or telephonically to coordinate member care
- Educate providers on utilization and medical management processes
- Provide clinical knowledge and act as a clinical resource to non-clinical team staff
- Enter and maintain pertinent clinical information in various medical management systems
Requirements:
- LVN Certificate
- CA Registered LVN
- Located within 50 miles of Los Angeles, CA
- 3 years of experience in Prior Authorization/Utilization Review
-
Lvn Visiting Nurse
7 days ago
Riverside, United States TRIUNE HOME HEALTH PROVIDER Full timeWe are a family owned home health care service. We have an open position for home health Licensed Vocational Nurses to visits home bound patients based on our Registered Nurse Evaluations and Doctors orders. **Job Types**: Part-time, Per diem Pay: $45.00 per hour **Experience**: - Home health: 1 year (preferred) License/Certification: - LVN...
-
Lvn - Home Health/hospice/palliative Care
4 days ago
Riverside, United States Kaiser Permanente Full time**Job Summary**: Provides nursing care to patients under the direction of a Registered Nurse utilizes observational skills to assess nursing intervention and assists medical staff to insure optimal patient care within established policies, procedures and standards. **Essential Responsibilities**: - Upholds Kaiser Permanentes Policies and Procedures,...
-
Lvn-home Health/hospice/palliative Care
6 days ago
Riverside, United States Kaiser Permanente Full time**Job Summary**: Provides nursing care to patients under the direction of a Registered Nurse utilizes observational skills to assess nursing intervention and assists medical staff to insure optimal patient care within established policies, procedures and standards. **Essential Responsibilities**: - Upholds Kaiser Permanentes Policies and Procedures,...
-
Lvn-home Health/hospice/palliative Care
4 days ago
Riverside, United States Kaiser Permanente Full time**Job Summary**: Provides nursing care to patients under the direction of a Registered Nurse utilizes observational skills to assess nursing intervention and assists medical staff to insure optimal patient care within established policies, procedures and standards. **Essential Responsibilities**: - Upholds Kaiser Permanentes Policies and Procedures,...
-
Lvn-home Health/hospice/palliative Care
2 hours ago
Riverside, United States Kaiser Permanente Full time**Job Summary**: Provides nursing care to patients under the direction of a Registered Nurse utilizes observational skills to assess nursing intervention and assists medical staff to insure optimal patient care within established policies, procedures and standards. **Essential Responsibilities**: - Upholds Kaiser Permanentes Policies and Procedures,...
-
Licensed Vocational Nurse Needed
15 hours ago
Riverside, United States Aveanna Healthcare Full timeJob DescriptionJob DescriptionPosition OverviewThe Licensed Vocational Nurse (LVN) is responsible for providing and documenting skilled nursing care, under the supervision of a Registered Nurse, in accordance with the developed care plan and physicians orders for each individual patient while adhering to confidentiality standards and professional boundaries...
-
Clinical Nurse Manager
7 days ago
Riverside, United States Veracity Software Inc Full timeClinical Nurse Manager Riverside, California Essential Job Duties: Operate a high-performing, well-equipped, and safe clinic, as well as ensure workflow efficiency, clarity, and protocols Hire, retain, coach, develop, supervise, and ensure the RN Case Managers, Clinic RN, Medical Assistants, and other clinic team members are engaged and...
-
Technician Shop Custodian
6 days ago
Riverside, United States Walter's Automotive Group Full timeWalter's Auto Group has been a staple in the Riverside area for over 50 years. Mercedes Benz, Porsche, and Audi are a beloved global icon & our committed specialists have years of experience satisfying our customers' needs. We aren't like most dealerships; we have a close-knit, open communication team environment. You will have leadership's support and...
-
Dealership Custodian
1 week ago
Riverside, United States Walter's Automotive Group Full timeWalter's Auto Group has been a staple in the Riverside area for over 50 years. Mercedes Benz, Porsche, and Audi are a beloved global icon & our committed specialists have years of experience satisfying our customers' needs. We aren't like most dealerships; we have a close-knit, open communication team environment. You will have leadership's support and...
-
BUDGET ANALYST
Found in: Dice One Red US C2 - 4 days ago
North Riverside, United States Department of the Army Full timeDuties As a BUDGET ANALYST (TITLE 32), GS-0560-11, you will provide management oversight and guidance to the budget formulation and execution process. Major Duties - This is NOT an all-inclusive list: * Provide management oversight to the budget process, including planning, programming, budgeting, allocation, and execution of funds. * Review annual...
-
ER CHARGE RN
Found in: Careerbuilder One Red US C2 - 2 days ago
Riverside, CA 92501, USA, United States Ahmc Healthcare Inc. Full timeOverviewThe RN Charge Nurse will be responsible for coordinating the nursing care on their shift; Responsible for overseeing ER patient Flow. Focus will be on providing a safe, effective environment for patients and staff through increased communication and customer service.JOB RELATIONSHIPS:Supervised by: Director of Critical Care ServicesSupervisor of:...
-
Nurse Supervisor
6 days ago
Riverside, United States CareerBuilder Full timeOverview: The Nursing House Supervisor is responsible for promoting and maintaining quality patient care through effective management of the activities of the total patient care services during his/her assigned shift. In the absence of the Hospital Administrator and/or designee, the Nursing House Supervisor has the authority and responsibility for...
-
Nurse Supervisor
7 days ago
Riverside, United States AHMC Healthcare Full timeOverview: The Nursing House Supervisor is responsible for promoting and maintaining quality patient care through effective management of the activities of the total patient care services during his/her assigned shift. In the absence of the Hospital Administrator and/or designee, the Nursing House Supervisor has the authority and responsibility for...
-
Fugitive Recovery Agent
7 days ago
Riverside, United States Bail Hotline Full timeJob DescriptionJob DescriptionFugitive Recovery Investigations, Inc. has an opening for a contracted Fugitive Recovery Agent on its Inland Empire Team. The ideal applicant will have a basic understanding of CA bail law and practice as well as a basic understanding of the CA Penal Code and other compliance codes, prior law enforcement and/or military...
-
Adjunct Faculty
2 weeks ago
Riverside, United States Marsha Fuerst School of Nursing Full timeJob DescriptionJob DescriptionSuccess Education Colleges (SEC) is a family of institutions comprised of Marsha Fuerst School of Nursing at North-West College. Glendale Career College and Nevada Career Institute. SEC is a leader in allied health education, and has been offering quality and affordable health care training programs for over 55 years. Our...
-
ELECTRONICS MECHANIC SUPERVISOR
Found in: Dice One Red US C2 - 1 week ago
North Riverside, United States Department of the Army Full timeDuties As a ELECTRONICS MECHANIC SUPERVISOR (TITLE 32), WS-2604-11, you will be responsible for supervising workers directly or through subordinate leaders and/or supervisors in accomplishing the work of the function. Major Duties - This is NOT an all-inclusive list: * Investigate work related problems such as excessive costs or low productivity and...
-
Class A OTR Driver
1 week ago
Riverside, United States Kelly Mobile Services Full timeJob DescriptionJob DescriptionKelly Mobile Services is a family-owned and operated transportation and rigging company, supporting the mobile medical industry since 1985. What we do matters! Our services directly affect patient care. Without our drivers ability to safely move mobile imaging trailers there would be many patients that never get treatment. This...
-
Resident Advocate-Long Term Care Ombudsman
2 weeks ago
Riverside, United States Council On Aging Full timeJob DescriptionJob DescriptionDescription:POSITION TITLE: Resident Advocate (Field Long Term Care Ombudsman) - Riverside and Coachella ValleyFSLA Category: Non-ExemptCompensation: $18- $21/hourPURPOSE: To investigate and resolve complaints made by or on behalf of residents living in nursing and residential care homes. To provide advocacy and mediation to...
-
RN Case Manager
7 days ago
Riverside, United States Integrated Resources, Inc Full timeJob Title: RN Case Manager Location : Riverside, CA Duration : 3+ Months (Possibility of extension) Shift : 8 Hours X 5 days (40 Hours/week) 08:00 AM to 05:30 PM Pay Range : $70/Hourly Gross to $72/Hourly Gross (Weekly Per Diem available for candidates 50 miles away from facility) Requirements : BLS and State License ...
-
Service Department Cashier
Found in: Lensa US P 2 C2 - 1 week ago
Riverside, United States BMW of Riverside Full timeOverview: The Service Department Cashier courteously and efficiently manages all service and repair transactions for our valued customers. He or she receives and processes payments for services rendered or parts and materials purchased, explains vehicle service recommendations to customers, and completes estimates and invoices. The Service Department Cashier...