Care Review Clinician, Inpatient Review

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...

**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...

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****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...

**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...

Job DescriptionJob DescriptionFacility OverviewAt 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...

Job DescriptionJob DescriptionFacility OverviewAt 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...

**_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...

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...

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 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...

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 DescriptionJob DescriptionFast growing, successful and well respected personal injury law firm based in West Palm Beach County, Florida is looking for a legal assistant to join their team. This is an ideal position for a hard-working, highly motivated person looking for an opportunity to grow within a fast past environment in the legal field and to help...

Job DescriptionJob DescriptionRapidly growing Florida Workers Compensation and personal Injury law firm is seeking a highly capable and motivated paralegal, who has a minimum of 3 years’ experience in workers compensation. Applicants must be able to multi-task, possess a high level of accuracy and attention to detail, and must be able to exist in a...

Job DescriptionJob DescriptionThis telework opportunity provides the ability to customize your schedule and caseload within the week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.Preferred candidates will hold a NY License, and be NY WC Board Certified.JOB...

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...

**Responsibilities**: - Review supplemental documents and evidence related to different case types, making edits accordingly. - Revise and proofread Immigration related forms for different case types. - Ensure the cases are reviewed in a timely manner and in accordance to the company’s guidelines. - Communicate efficiently with different team members and...