Clinical Reviewer LVN

About the Position:Molina Healthcare is seeking a highly skilled Clinical Review Nurse to join our team as a SIU Investigator. As a Clinical Review Nurse, you will be responsible for reviewing and analyzing information to make medical determinations and applying clinical knowledge to assess the medical necessity of services.Responsibilities:Review and...

Role OverviewThe Facility Compliance Review team at Blue Shield of CA reviews post-service prepayment facility claims for contract compliance, industry billing standards, and medical necessity. As a Utilization Management Nurse, Senior, you will be responsible for reviewing medical documents and applying clinical criteria to establish the most appropriate...

About the RoleThis is an exciting opportunity for a skilled nurse to join our Utilization Management team as a Clinical Review Nurse. In this role, you will be responsible for conducting thorough reviews of prior authorization requests, analyzing medical records, and making informed decisions regarding coverage.You will work closely with our Medical Director...

LVN Job SummaryWe are seeking a skilled and experienced Licensed Vocational Nurse (LVN) to join our team at The Children's Clinic. As an LVN, you will provide direct patient care, assist with medical procedures, and contribute to the smooth operation of our clinic.

About the RoleThis position offers a unique opportunity to make a meaningful difference in the lives of individuals struggling with addiction and mental health issues. As an LVN at BH Services, Inc., you will play a vital role in providing compassionate and personalized care.Key ResponsibilitiesThe successful candidate will be responsible for:Assessing...

**Job Summary**We are seeking a highly skilled Licensed Vocational Nurse to join our team at The Children's Clinic. As an LVN, you will play a vital role in providing exceptional patient care and supporting our healthcare professionals in delivering quality services.**About The Company**The Children's Clinic is a renowned healthcare organization dedicated to...

ResponsibilitiesPerform retrospective utilization reviews and first-level determination approvals for members using evidence-based guidelines, policies, and nationally recognized clinical criteria.Conduct clinical review of claims for medical necessity, coding accuracy, medical policy compliance, and contract compliance.Prepare and present cases to Medical...

Job Overview:The Clinical Nursing Supervisor at The Children's Clinic plays a crucial role in ensuring the delivery of high-quality patient care. This position is responsible for overseeing the day-to-day activities of the back office staff, clinical compliance, and nursing medications.Responsibilities:Floor Supervision: Collaborate with LVNs to coordinate...

About the RoleThis Hospice LVN Intake/Office Coordinator position offers a unique opportunity to make a meaningful impact in the lives of veterans and their families.As a key member of our team, you will be responsible for coordinating new patient admissions and ensuring seamless office operations.If you possess clinical expertise, excellent communication...

About the Role:Molina Healthcare is seeking a skilled Medical Review Auditor RN to join our team. As a key member of our Special Investigation Unit (SIU), you will play a vital role in supporting the prevention, detection, investigation, reporting, and recovery of money related to healthcare fraud, waste, and abuse.About You:To be successful in this role,...

Job Title: Clinical Leadership RoleThis is an exciting opportunity to join Tarzana as a Licensed Clinical Supervisor for our Residential program in Long Beach. As a supervisor, you will be responsible for overseeing mental health services provided through our DMH contract. The ideal candidate will have a minimum of 2 years' experience as an LCSW, LMFT, or...

LVN/Back Office Supervisor Job DescriptionWe are seeking an experienced LVN to fill the role of LVN/Back Office Supervisor. This position involves supervising medical assistants and licensed vocational nurses, maintaining regulatory compliance, and coordinating clinic orientation.Key ResponsibilitiesPatient CareAssist Clinic Providers with treatments,...

Job Summary: Molina Healthcare Services 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. Our goal is to ensure that patients progress toward desired outcomes with...

Job DetailsVivo HealthStaff is hiring Clinical Support Staff to work in COVID-19 testing centers across Sacramento.The successful candidate will have an active and unrestricted LVN, CNA, or Medical Assistant License and a friendly and eager to learn attitude.Responsibilities include:Collecting testing kits from patients in a safe and efficient mannerWe offer...

Clinical Utilization Specialist, SeniorThe Clinical Utilization Specialist, Senior plays a critical role in the Facility Compliance Review team at Blue Shield of California.Responsibilities include reviewing post-service prepayment facility claims for compliance with contract requirements, industry standards, medical necessity, and hospital-acquired...

Required QualificationsGraduate from an Accredited School of Nursing Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health, or social work field).2+ years in case management, disease management, managed care, or medical or behavioral health...

Job Title: Clinical Audit Specialist**Salary:** $70,000 - $90,000 per yearWe are seeking a skilled Clinical Audit Specialist to join our team at Molina Healthcare. In this role, you will be responsible for supporting the prevention, detection, investigation, and reporting of healthcare fraud, waste, and abuse.Key Responsibilities:Perform accurate and...

About the RoleWe are seeking a part-time licensed Clinical Supervisor (LMFT, LCSW or Psy.D) with experience in substance use, mental health and trauma for our outpatient treatment program in Long Beach, CA.In this role, you will provide supervision and oversight for adolescent and youth programs, review assessments and medical records for potential...

About the RoleIn this role, you will provide supervision and oversight for our adolescent program, review assessments and medical records, conduct utilization reviews, help develop and manage program schedules, complete documentation, and provide clinical services.

**Job Summary:**We are seeking a skilled Licensed Vocational Nurse (LVN) to join our team at Behavioral Health Services, Inc. As an LVN, you will play a vital role in providing high-quality patient care in our substance abuse detox subacute hospital.**Responsibilities:Patient Care: Assess patients and provide nursing care in accordance with physicians'...