Care Review Clinician (RN/LPN) - Utilization Management
Molina Healthcare of Illinois
Molina Healthcare in San Diego, California, is seeking a Clinical Member Services Reviewer to support quality and cost-effective member care. This role requires a minimum of 2 years in healthcare and involves assessing services, analyzing requests, and ensuring compliance with regulations. The ideal candidate will have strong organizational, problem-solving, and communication skills, along with proficiency in Microsoft Office and relevant clinical licensure. A competitive benefits package is included. #J-18808-Ljbffr
$27.61 - $53.83 per hour
...Provides support for clinical member services review assessment processes. Responsible for... ...through integrated delivery of care across the continuum. Contributes to overarching... ...the Molina care model. Adheres to utilization management (UM) policies and procedures. Required...SuggestedHourly payContract workWork experience placementWork at office$27.61 - $53.83 per hour
...Provides support for clinical member services review assessment processes. Responsible for... ...through integrated delivery of care across the continuum. Contributes to overarching... ...the Molina care model. • Adheres to utilization management (UM) policies and procedures....SuggestedHourly payContract workWork experience placementWork at office- ...transformative mental health care and educational... ...The Nurse (LVN or RN) creates a safe... ...are always utilized in dispensing and... ...and notifies Nurse Manager and Physician of client... ...of the hold. Clinician approval for any hold... ...and treatment reviews as assigned....SuggestedReliefShift workWeekend work
- ...Senior Care Manager The Care Management team will serve to support... ...perform a blended function of utilization management (UM) and care management... ...). Conducts member care review with medical groups or... ...Experience: ~ Current CA RN License required ~ Bachelor...SuggestedFull timeContract workPart timeWork at officeLocal areaWork from homeHome office2 days per week
$2,169 per week
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...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: National City, CA Agency: Advantis Medical Staffing... ...with our personalized service where we set the gold standard in clinician care. As a Joint-Commission-certified agency, we promise a seamless...Full timeContract workImmediate startShift workNight shift$1,308.13 per week
...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: National City, CA... ...) - ER Emergency Room to join our growing clinician community. This high-impact opportunity offers... ...rooted in collaboration, integrity, and care. We proudly support our local healthcare communities...Weekly payDaily paidFull timeContract workLocal areaImmediate startFlexible hoursShift workNight shift$1,308.13 per week
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...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: National City, CA Agency: Advantis Medical Staffing... ...with our personalized service where we set the gold standard in clinician care. As a Joint-Commission-certified agency, we promise a seamless...Full timeContract workImmediate startShift workNight shift$2,124 per week
...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: National City, CA... ...centric principles placing our clients’ and clinicians’ best interests first with our commitment... ...be an infectious agent of quality care wherever they go. Join us, work...Daily paidFull timeContract workImmediate startShift workNight shift- ...Patient Care Coordinator - Hospice - Part Time -... ...clinical authorizations review and auditing... ...Care Services and staff clinicians to gather, collate, and... ...summary information to Case Managers. Regularly participate... ...ensure proper staff utilization and confirms that...Part timeWork at officeLocal areaFlexible hours
$42 - $44 per hour
...beds. We focus on compassionate care, empowering patients to... ...5‑star Customer Satisfaction Management (CSM) rating, reflecting our commitment... ...Assist the Station Manager/RN Nurse Supervisor in determining... ...Manager/RN Nurse Supervisor. Review complaints and grievances made...Hourly payShift work$23 - $37.81 per hour
...nonprofit health care provider, we deliver... ...Assist clinicians with patient flow... ...before administration utilizing the order as entered... ...certification) Review patient record and... ...assist in the case management of patient populations... ...inventory Report to RN or Nurse Manager...Hourly payFull timeWork at office- ...beds. We focus on compassionate care, empowering patients to... ...5-star Customer Satisfaction Management (CSM) rating, reflecting our commitment... ...Assist the Station Manager, RN Nurse Supervisor in... ...Manager, RN Nurse Supervisor. Review complaints and grievances made...Shift work
- ...PACE Home Care Coordination Supervisor Registered Nurse Job Description... ...and Care Coordination RN Manager, the Home Care Coordination... ...procedures. Conducts qualitative reviews and assesses documentation of... ...respect for patient rights, utilizing established mechanisms for...Work at officeLocal areaWeekend work
- ...Summary The Community Care RN Clinical Coordinator utilizes comprehensive clinical practice, case management, and utilization review principles to assess, triage, and plan the appropriate level of care and to ensure compliance with established guidelines resulting...Permanent employmentFull timeTemporary workPart timeSeasonal workImmediate startRemote workTrial periodRelocation packageFlexible hoursShift work
- ...Licensed Practical/Vocational Nurse (LPN/LVN) Arcetyp LLC is a... ...Commercial clients. Services include Management & IT Consulting, Program &... ...Functions: Ensure patient care is carried out in accordance... ...semiannually). Participate in peer review and performance improvement...Full timeLocal area
- ...Your Role The Care Management team will serve to support the mission of the department,... ...Managers perform a blended function of utilization management (UM) and care management (CM... ...Knowledge and Experience ~ Current CA RN License required ~ Bachelor of...Full timeWork at office
- ...program office after review of the EDRP... ...in direct patient care positions unless they... ...goal setting for managing complex client situations... ...Mental Health RN assumes the... ...supervising patient care Utilizes designated... ...evaluated by another clinician in the same day Applies...Permanent employmentFull timeTemporary workWork at officeImmediate startRemote workTrial periodRelocation packageFlexible hoursShift work
- ...compliance and accuracy. This role requires a current California nursing license and a minimum of one year of experience in long-term care or geriatric nursing. You'll provide training and support to staff, coordinate assessments, and ensure timely submissions. Join a...
$200k
...program office after review of the EDRP application... ...clinic Mental Health RN assumes the following... ...or supervising patient care. Utilizes designated templates for... ...follow-up. May manage secure messages as designated... ...evaluated by another clinician in the same day. Applies...Permanent employmentFull timeTemporary workSeasonal workWork at officeImmediate startRemote workTrial periodRelocation packageFlexible hoursShift work- ...and empower yourself to deliver innovative care. Be a part of an extraordinary team,... ...hospitals. As a Float Pool MedSurg/Tele RN at Mercy Hospitals, you will thrive in an... ...Title Transfers to other locations will be reviewed on a case-by-case basis and may result in...Part timeShift workDay shift
- ...healthcare system that values patient-centered care and celebrates the extraordinary work you... ...and family-centered care in mind, the RN takes primary responsibility for the patients... ...Transfers to other locations will be reviewed on a case-by-case basis and may result in...Full timeRemote workRelocation packageShift workNight shiftWeekend work
$59.16 - $85.68 per hour
...Position Overview Full-time RN position with 12-hour shifts (72 hours per pay period)... ...Responsibilities include providing direct patient care that includes assessment, planning and... ...Transfers to other locations will be reviewed on a case-by-case basis and may result in...Hourly payFull timeRelocation packageShift workNight shiftWeekend work$30 - $35 per hour
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Become a part of our caring community As a CenterWell... ...reporting to the Clinical Manager, you will provide... ...team of physicians and clinicians, you'll manage care plans... ...under the direction of an RN. Implement... ...years experience as an LPN/LVN in a clinical setting...Weekly payFull timeTemporary workApprenticeship$131.34k - $184.08k
(RN) Registered Nurse - Transplant Coordinator job at UC San Diego... ...2011. Autonomous nursing care is the ability of a nurse to assess... ...and support in treating and managing the pre and post-transplant... ...hired at the CNIII level pending review and approval by the Nurse...Hourly payLocal areaDay shift$2,162 per week
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...Become a part of our caring community The Patient Services Coordinator-LPN is directly responsible for scheduling visits... ...with day-to-day office and staff management Responsibilities Manages schedules... ...Schedules. Performs initial review of weekly schedule for productivity...Temporary workApprenticeshipWork at office$90k - $100k
...50% on surgical and specialty care. By partnering with a hand-selected... ...upfront bundled pricing, and clinician-led navigation. The Role The... ...record collection process Manage inbound and outbound calls, proactively... ...SF 6 days/mo Preferred LVN or RN with clinical experience in...Work at officeRemote work
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