Inpatient Review

**JOB DESCRIPTION**Care Review Clinician, Inpatient Review- Behavioral HealthFor this position we are seeking a RN (Registered Nurse) who lives in and must be licensed for the state they reside. Strong inpatient medical and analytical experience is needed. Excellent computer multi-tasking skills and good productivity is essential for this fast-paced role....

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 SummaryWe are seeking a highly skilled LPN Medical Reviewer to join our team at PGBA. As a Medical Reviewer, you will play a critical role in evaluating medical records to determine medical necessity and performing utilization management of professional, inpatient, outpatient facility benefits or services and appeals.Key ResponsibilitiesEvaluate medical...

Job DescriptionJob DescriptionInpatient Coder (CCS Required)Location: Fully remote - Must be in approved state (Alabama, Arkansas, Florida, Illinois, Louisiana, Michigan, New Hampshire, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Wisconsin)Experience Level: ExpertEmployment Type: 6 month contract to hire...

Your RoleThe Utilization Management team at Blue Shield of CA reviews inpatient stays for our members under nationally recognized levels of care guidelines.The Senior Utilization Management Nurse will report to the Utilization Management Nurse Manager.In this role, you will be assigned a list of inpatient facilities and review clinical information provided...

Job Summary:The Registered Nurse (Case Management) role reports to the Chief Medical Officer and is primarily focused on virtual work. Key responsibilities include supporting census management, reviewing patient data across inpatient, ER, and skilled nursing facility stays, outreaching to hospital case managers, coordinating transitions of care and...

Team Manager Inpatient (RN)Patient Care Services * Directs all patient care services for the team, including volunteer and bereavement, and ensures that services are rendered as integrated components of the interdisciplinary plan of care. * Reviews information on all pending patient admissions, all new admissions (assessments and history) and "alive"...

Team Manager Inpatient (RN)Patient Care Services * Directs all patient care services for the team, including volunteer and bereavement, and ensures that services are rendered as integrated components of the interdisciplinary plan of care. * Reviews information on all pending patient admissions, all new admissions (assessments and history) and "alive"...

*Tuesday - Saturday shift, work hours are 8am-5pm Pacific Time Zone*Remote role - CA LVN requiredAbout SCANSCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare...

Job DescriptionJOB DESCRIPTIONJob SummaryMolina 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...

Title: Registered Nurse (RN) Location: Long Beach, CA Department: Pediatrics- MCH West Status: Full-time Shift: Nights (12hr shifts) Pay Range*: $47.28/hr - $75.69/hr MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups - consisting of over 200 sites of care, and more than 2,000...

*Tuesday - Saturday shift, work hours are 8am-5pm Pacific Time Zone*Remote role - CA LVN requiredAbout SCAN SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare...

Description Title: Registered Nurse (RN) Location: Long Beach, CA Department: Pediatrics- MCH West Status: Part-time Shift: Nights (12hr shifts) Pay Range*: $47.28/hr - $75.69/hr MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care,...

Description Title: Registered Nurse (RN) Location: Long Beach, CA Department: Pediatrics- MCH West Status: Full-time Shift: Nights (12hr shifts) Pay Range*: $47.28/hr - $75.69/hr MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups - consisting of over 200 sites of care, and more...

Description Title: Registered Nurse (RN) Location: Long Beach, CA Department: Pediatrics- MCH West Status: Full-time Shift: Nights (12hr shifts) Pay Range*: $47.28/hr - $75.69/hr MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care,...

Job OverviewThe Vice President and Chief Operating Officer plays a pivotal role in managing the overall operation of the facilities and programs of Stars Behavioral Health Group. This individual works closely with the CEO and executive team to set company performance goals, develop and implement strategies, procedures, and business plans to enhance company...

Team Manager Inpatient (RN)Patient Care Services * Directs all patient care services for the team, including volunteer and bereavement, and ensures that services are rendered as integrated components of the interdisciplinary plan of care. * Reviews information on all pending patient admissions, all new admissions (assessments and history) and "alive"...

Regional Sales Manager (WEST COAST)Seniority Level: Senior Level (4+ years of related outside sales experience, with a demonstrable book of business)Wage: 100-150k + commissionWork Location: Preferably, a Sales Manager for the Transportation, Freight Forwarding, Logistics, Supply Industries:  region who will be based in our Long Beach office Industries:...

Your Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting.  The Clinical Quality Analyst - Senior will...

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...