Utilization Review RN
6 days ago
About Us:
Madera Community Hospital is a General Acute Care, private, not-for-profit hospital located in the heart of Central California. We are committed to improving and maintaining the health and wellness of residents throughout the Central Valley, and we take pride in our reputation for providing exceptional patient care and service.
Job Description:
The Utilization Review Nurse will be responsible for assessing, planning, implementing, and evaluating the needs of patients for discharge planning and utilization review. This includes ensuring that patients receive the necessary care and services to meet their medical needs, while also minimizing costs and maximizing efficiency.
Responsibilities:
- Conduct thorough assessments of patients' medical needs and develop individualized plans for discharge and utilization review
- Collaborate with physicians, nursing staff, and other healthcare professionals to ensure seamless care transitions
- Develop and maintain relationships with payers and other stakeholders to ensure optimal reimbursement and billing practices
- Analyze data and trends to identify opportunities for process improvement and cost reduction
- Develop and implement policies and procedures to ensure compliance with regulatory requirements and industry best practices
Qualifications:
- Minimum of 1-3 years of experience in acute healthcare, preferably in case management or utilization review
- Current California Board of Nursing Registered Nurse License
- Current American Heart Association BCLS certificate, ACLS certificate preferred
- Knowledge of Medicare, Medicaid, HMO, and private insurance coverage criteria
- Excellent communication and interpersonal skills
- Ability to work effectively in a fast-paced environment, prioritizing tasks and managing multiple projects simultaneously
Salary:
$55.34-$66.41/hourly
Benefits:
- Comprehensive benefits package, including medical, dental, and vision insurance
- Retirement savings plan, including 401(k) matching program
- Generous paid time off policy, including vacation, sick leave, and holidays
- Opportunities for professional growth and development, including tuition reimbursement and continuing education programs
-
Project Coordinator
1 month ago
Madera, California, United States Arrow Construction Full timeJob OverviewWe are seeking a highly skilled Project Coordinator to support our operations team at Arrow Construction.ResponsibilitiesManage incoming work orders, determining status and logging into the dispatching system.Submit permit applications when required and coordinate payment/pickup with the Paving Superintendent.Maintain accurate status of each work...
-
Nurse Travel Professional
4 weeks ago
Madera, California, United States Health Carousel - Travel RN Full timeHealth Carousel, a leading healthcare staffing brand, is currently seeking an experienced Travel Nurse RN to join their team as a PICU - Pediatric Intensive Care professional in Madera, California.Job SummaryWe are looking for a skilled and dedicated travel nurse to provide exceptional care to pediatric patients in a fast-paced intensive care environment. As...
-
Clinical Nurse Specialist
2 weeks ago
Madera, California, United States Madera Community Hospital Full timeMadera Community Hospital: A Growing Acute Care FacilityLocated in the heart of Central California, Madera Community Hospital is a General Acute Care, private, not-for-profit hospital dedicated to improving and maintaining the health and wellness of residents throughout the Central Valley. We are committed to identifying and serving our community's needs...
-
Construction Operations Coordinator
1 month ago
Madera, California, United States Arrow Construction Full timeAbout UsArrow Construction is a full-service underground utilities construction company based in Sacramento, CA. We serve northern and central California and western Nevada with our services including underground utility work, vacuum excavation, asphalt/concrete restoration and traffic control services.Our PhilosophyWe pride ourselves on customer...
-
Financial Operations Manager
1 week ago
Madera, California, United States Madera Community Hospital Full timeJob SummaryMadera Community Hospital seeks a seasoned financial expert to drive revenue growth and optimize profitability.Estimated Salary: $306,000-$367,000 annuallyKey Responsibilities:Develop and implement strategic financial plans to enhance asset utilization and reduce costsAnalyze market trends and negotiate favorable contract terms with third-party...
-
External Union Growth Specialist
6 days ago
Madera, California, United States United Farm Workers of America Full timeWe are seeking a highly skilled Labor Rights and Membership Coordinator to join our team. This role plays a crucial part in planning, directing, and coordinating UFW membership growth. The successful candidate will assist in managing and directing worker activities during the collective bargaining process.About the Role:As a Labor Rights and Membership...
-
Madera, California, United States Host Healthcare Full timeHost Healthcare is seeking a skilled Travel Nurse RN to fill a PICU - Pediatric Intensive Care position in California.About the JobPICU - Pediatric Intensive Care Specialty: Provide critical care services to pediatric patients.RN Discipline: Utilize your nursing expertise to deliver high-quality patient care.We are offering $120/hour pay package for 12 hour...
-
PACU Nurse Specialist
6 days ago
Madera, California, United States Madera Community Hospital Full timeJob OverviewMadera Community Hospital is a leading healthcare provider in Central California, dedicated to delivering exceptional patient care and improving community health.We are seeking a skilled PACU Registered Nurse to join our team, who will utilize the nursing process to identify patient needs and provide high-quality care in a dynamic...
-
Pediatric Nursing Specialist
4 weeks ago
Madera, California, United States Supplemental Health Care Full timePediatric Nursing Job in CaliforniaSupplemental Health Care is a renowned healthcare staffing agency, dedicated to providing world-class service and supporting talented professionals in their life calling. As a pediatric nursing specialist with Supplemental Health Care, you will have the opportunity to work in a dynamic environment, utilizing your skills and...
-
Operations Support Specialist
2 weeks ago
Madera, California, United States Arrow Construction Full timeArrow Construction, a full-service underground utilities construction company based in Sacramento, CA, is seeking a talented individual to support its operations team.The Assistant Project Manager will play a crucial role in ensuring the smooth execution of projects. Key responsibilities include:Receiving incoming work orders from the Work Order Clerk and...
-
Organizer and Community Developer
7 days ago
Madera, California, United States United Farm Workers of America Full time**United Farm Workers of America is hiring an External Union Growth Specialist.**Job Description:The United Farm Workers of America seeks a highly skilled External Union Growth Specialist to join our team. This role plays a crucial part in planning, directing, and coordinating UFW membership growth. The successful candidate will assist in managing and...
-
Case Management Specialist
2 weeks ago
Madera, California, United States Madera Community Hospital Full timeJob Opportunity at Madera Community Hospital:About Us:Madera Community Hospital is a General Acute Care facility located in the heart of Central California. We're committed to identifying and serving our community's needs with compassion and care.Job Role:The Case Manager RN will assist in the development and implementation of the case management program....
-
NICU Registered Nurse
2 weeks ago
Madera, California, United States Host Healthcare Full timeAdvanced NICU Nursing Opportunity in Madera, CAAbout the Role:We are seeking a highly skilled and compassionate Registered Nurse to join our team as a NICU travel nurse in Madera, CA. This is an exciting opportunity for you to utilize your expertise and make a meaningful difference in the lives of critically ill newborns and their families.What You'll...
-
Madera, United States Universal Health Services Full timeJob SummaryWe are seeking a highly skilled Behavioral Health Utilization Management Coordinator to join our team at Universal Health Services. This role will involve facilitating a continuum of service while promoting positive outcomes and optimal reimbursement through coordination of patient care, daily clinical reviews, quality documentation, appeals, and...
-
Psychiatric UM RN
3 weeks ago
Madera, United States UHS Full timeJob SummaryWe are seeking a skilled RN to join our Utilization Management team. As a key member of our multidisciplinary treatment team, you will be responsible for coordinating patient care, conducting daily clinical reviews, and ensuring timely authorization for continued treatment with payers.
-
Travel Nurse RN
4 weeks ago
Madera, United States Cynet Health Full timeJob Title: Registered Nurse Job Specialty: Pediatric Intensive Care (PICU) Job Duration: 13 weeks Shift: 7:00 AM - 7:30 PM Guaranteed Hours: 0 Experience: Not specified License: RN Certifications: Not specified Must-Have: Orientation completion Job Description: - Provide high-quality, compassionate care to pediatric patients in an intensive care unit. -...
-
Travel Nurse RN
2 months ago
Madera, United States Cynet Health Full time**Job Title:** Registered Nurse**Job Specialty:** Pediatric Intensive Care (PICU)**Job Duration:** 13 weeks**Shift:** 7:00 AM - 7:30 PM**Guaranteed Hours:** 0**Experience:** Not specified**License:** RN**Certifications:** Not specified**Must-Have:** Orientation completion**Job Description:**- Provide high-quality, compassionate care to pediatric patients in...
-
Assistant Project Manager
7 months ago
Madera, United States Arrow Construction Full time $25 - $35ASST PROJECT MANAGER, Fresno CASalary Range $25 to $35 per hourFormed in 1995, Arrow Construction is a full-service underground utilities construction company based in Sacramento, CA and serves northern and central California and western Nevada. Our services include underground utility work, vacuum excavation, asphalt/concrete restoration and traffic control...
-
Medical Director
13 hours ago
Madera, United States TRADITIONS BEHAVIORAL HEALTH Full timeABOUT OUR PARTNER Madera County Services - Madera, CA The Madera County Department of Public Health (MCDPH) protects the health of our community by preventing disease and promoting health equity. They offer mental health and alcohol and drug services for all ages through education, prevention, early intervention, crisis services, assessments, case...
-
Licensed Vocational Nurse
4 days ago
Madera, United States Golden Madera Care Center Full time $29 - $34Licensed Vocational Nurse (LVN)Find out if this opportunity is a good fit by reading all of the information that follows below.Now Hiring for Fulltime PM Shift 2:30pm -11:00 pm, 4 on 2 off rotationWe’re so happy that you’re considering a career with us!Evergreen Healthcare stands as an excellent choice for those seeking a fulfilling career. Comprising a...
-
Product Engineer
3 months ago
Madera, United States Oldcastle Infrastructure Full timeOldcastle Infrastructure™, a CRH company, is the leading provider of utility infrastructure solutions for the water, energy, and communications markets throughout North America. We’re more than just a manufacturer of precast concrete, polymer concrete, or plastic products. We’re a trusted and strategic partner to engineers, contractors, distributors,...
-
Product Engineer
5 days ago
Madera, United States Oldcastle Infrastructure Full timeOldcastle Infrastructure™, a CRH company, is the leading provider of utility infrastructure solutions for the water, energy, and communications markets throughout North America. We’re more than just a manufacturer of precast concrete, polymer concrete, or plastic products. We’re a trusted and strategic partner to engineers, contractors, distributors,...
-
Staff Accountant I or II
1 day ago
Madera, United States Span Construction Full timeStaff Accountant I About Us: Span Construction & Engineering, Inc. is a pioneer in the pre-engineered metal building erection industry, proudly operating as a 100% employee-owned company (ESOP) in the building industry. Since our inception in 1980 we've fostered enduring relationships as trusted advisors with our valued clients. We are the number one builder...
-
Home Health Nurse
4 days ago
La Madera, United States Giving Home Health Care Full time $30 - $50Since 2012, Giving Home Health Care has helped individuals impacted by conditions contracted while working in nuclear energy programs for the Department of Energy achieve compassionate and personalized in-home health care. We are a fast-growing, leading health care organization with services offered in Arizona, Colorado, Kentucky, Missouri, Nevada, New...
-
Occupational Therapist
4 months ago
Madera, United States Madera County Superintendent of Schools Full timeMADERA COUNTY SUPERINTENDENT OF SCHOOLS CLASS TITLE: OCCUPATIONAL THERAPIST BASIC FUNCTION: Under the direction of Director, Special Education Programs and Services, to provide occupational therapy treatment to special needs students enrolled in the educational programs of the Local Education Agencies (LEA). This job class administers occupational therapy...
-
Home Health Nurse
4 weeks ago
La Madera, NM, United States Giving Home Health Care Full timeSince 2012, Giving Home Health Care has helped individuals impacted by conditions contracted while working in nuclear energy programs for the Department of Energy achieve compassionate and personalized in-home health care. We are a fast-growing, leading health care organization with services offered in Arizona, Colorado, Kentucky, Missouri, Nevada, New...