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 CASE MANAGER(22)  MANAGEMENT(5)
 AUDITOR  CLAIMS (1)
 CODER


Case Manager Jobs 1-10 of 22 displayed.

JOB # LOCATION JOB TITLE QUALIFICATIONS TEMP/PERM GET INFO
18A* Encino, CA LVN - Authorization, Case Manager - Health Plan

About the Job:

    1. Fast Paced Office Environment.
    2. Monday - Friday; 40 Hours a Week
    3. Home Health or SNF Case Manager with 5+ years experience please apply
    4. Medical Office Administrator, Manager or Coordinator with 3+ years experience please apply


       

Temporary
20A* Santa Ana, CA Registered Nurse (RN) -Telephonic Complex, Case Manager - Health Plan

About the Job:

  • Fast Paced Office Environment.

  • Monday - Friday, 40 Hours a Week, 8 Hours a Day

  • Reviews, verifies and processes requests for referrals, outpatient/inpatient procedures, home health services, DME, Imaging, etc.​ through the telephone & fax.​

  • Computer literate for electronic documentation and data entry

  • Strong problem solving and organizational skills in a fast paced environment

    Able to meet production and quality work standards

Temporary
11A* Torrance, CA-South Bay Area Registered Nurse (RN) - QI/QA Nurse Case Manager

Experience / Must have:

 

  • Participates in development and implementation of Quality Improvement programs
  • To review health procedures and statistics.
  • To determine and document any areas that may need improvement.
  • Inspecting and sampling the entire process as a part of quality assurance.
  • To review the current policies and improvise plans to improve upon the existing quality standards.
  • To review and analyze the effectiveness of the modifications made.
  • Ensure the highest quality of care is provided and is in compliance with federal, state, and local regulatory requirements and established departmental policies and procedures.
  • Ensures accuracy & completeness of patient records
  • Ability to read and interpret medical record data for chart audits or abstractions. 
  • Ability to navigate database a plus.
  • Excellent written and oral communication skills.
  • Ability to work with a diverse team and have excellent organizational skills.

 

Temp-To-Hire
08A* Buena Park, CA Registered Nurse - Case Manager, Hospital (InterQual)  

Ability to: 

  • Admitting new patients by reviewing records and applications
  • Determine patient requirements by completing intake assessments.
  • Establishes treatment programs by setting schedules and/or routines; coordinating services being provided; arranging resources
  • Monitors cases by observing and evaluating treatments and responses
  • Obtaining additional resources; intervening in crises; providing personal support.
  • Maintains records by reviewing case notes; logging events and progress.

 

Temporary
30A* Al Hambra, CA Registered Nurse (RN)- Inpatient, Case Manager (Hospital ONLY)

About the Job:

  • Utilization Review
  • Concurrent Review
  • Discharge Planning
  • Med-Surg, ICU, Telemetry
  • Monday - Friday; 40 Hours a Week
  • InterQual Criteria
Temp-To-Hire
07A* Simi Valley, CA RN - Utilization Nurse Case Manager, Hospital - Case Manager

Ability to / Knowledge of:

  • Manage cases smoothly and increase patient/physician satisfaction.
  • Strong clinical assessment to provide utilization review and/or discharge planning services to patients with medical & emotional needs.

  • Track outcomes and report findings.
  • Working knowledge of methods to resolve patient needs such as discharge planning, Home Health, DME and SNF’s.
  • Use clinical knowledge to identify potential quality issues, delays in service, post-acute care needs.
  • Excellent verbal and written communication skills.

  • Negotiate orders with the physicians in order to assign alternate levels of care.

  • Working knowledge of reimbursement related to Medicare, Medi-Cal & Managed Care.

Temporary
01A* Irvine, CA 90026 Specialty Case Manager - Registered Nurse

Must be able to:    

  • Evaluate the quality of necessary medical services, and be able to acquire and analyze the cost of care.
  • Assist in the formulation of medical case management policies and procedures; understand and interpret policies, procedures and regulations.
  • Develop and maintain effective working relationships with all levels of staff, other programs, agencies, and the general public.
  • Communicate effectively at all organizational levels and in situations requiring instructing, persuading, negotiating, consulting, and advising.
  • Assess resource utilization, cost management and negotiate effectively.
  • Effectively utilize computer and appropriate software and interact as needed with Information Systems.
  • Prepare clear, comprehensive written and oral reports and materials.
 Requirements
  •  Requirements
      • California RN License
      • At Least Three Years Case Management Experience 
      • Strong Verbal and Written Communication
      • B.S.N. Preferred (Not Required)
 
Perm
26A* Los Angeles, CA Registered Nurse - Case Manager - Discharge Planning Requirements

Applicants should meet the following requirements:    
    -Active RN license  
    -Clinical background in patient assessment in an acute hospital setting    
    -3 years minimum healthcare sales and marketing experience

    -Minimum of 2 years nursing exp. in an Med/Surg setting and 1 year Critical Care exp.

Perm
25A* Los Angeles, CA Registered Nurse (RN) - Case Manager, Telephonic

Must be able to:    

  • Evaluate the quality of necessary medical services, and be able to acquire and analyze the cost of care.
  • Assist in the formulation of medical case management policies and procedures; understand and interpret policies, procedures and regulations.
  • Develop and maintain effective working relationships with all levels of staff, other programs, agencies, and the general public.
  • Communicate effectively at all organizational levels and in situations requiring instructing, persuading, negotiating, consulting, and advising.
  • Assess resource utilization, cost management and negotiate effectively.
  • Effectively utilize computer and appropriate software and interact as needed with Information Systems.
  • Prepare clear, comprehensive written and oral reports and materials.
Temporary
21A* Long Beach, CA Health Care, Claims - Examiner, Auditor Requirements
  1. Monday - Friday; Full Time
  2. Fast paced, production environment
  3. Ability to start relatively quickly 
  4. 5+ Years experience in claims
Temporary