Jobs
>
Rancho Cucamonga

    CA Utilization Review Case Manager I - Rancho Cucamonga, United States - CorVel Corporation

    CorVel Corporation
    CorVel Corporation Rancho Cucamonga, United States

    3 weeks ago

    Default job background
    Full time
    Description

    The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay; supporting the goals of the Case Management department, and of CorVel.

    Opportunity to work from home. Candidates must reside in Pacific Time Zone.

    ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Identifies the necessity of the review process and communicates any specific issues of concern to the appropriate claims staff/customer
  • Collects data and analyzes information to make decisions regarding certification or denial of treatment Documenting all work in the appropriate manner
  • Requires regular and consistent attendance
  • Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
  • Additional duties as required

    • KNOWLEDGE & SKILLS:

  • Must have a thorough knowledge of both CPT and ICD coding
  • Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment
  • Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers
  • Ability to promote and market utilization review products with attorneys and claims staff
  • Strong ability to negotiate provider fees effectively
  • Excellent written and verbal communication skills
  • Ability to meet designated deadlines
  • Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
  • Strong interpersonal, time management and organizational skills
  • Ability to work both independently and within a team environment

    • EDUCATION & EXPERIENCE:

  • Graduate of accredited school of nursing with a diploma/Associates degree (Bachelor of Science degree or Bachelor of Science in Nursing preferred)
  • Current Nursing licensure in the state of operation required
  • RN is required unless local state regulations permit LVN/LPN
  • 4 or more years of recent clinical experience
  • Previous experience in the following areas, preferred: Prospective, concurrent and retrospective utilization reviewExperience in the clinical areas of O.R., I.C.U., C.C.U., E.R., orthopedicsKnowledge of the workers' compensation claims processOutpatient utilization review

    • PAY RANGE:

    CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

    Pay Range: $ $43.72 per hour

    A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

    ABOUT CORVEL

    CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT).

    A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

    CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

    #LI-Remote

  • Hannah's Children's Homes

    Case Manager

    3 weeks ago

    Hannah's Children's Homes Rancho Cucamonga, United States

    Job Description · Job DescriptionWe are looking for a Case Manager to join our team The case manager will be responsible for assigning, monitoring, and organizing cases for social work. They will be directly involved in the lives of their clients, and provide resources and assist ...

  • SIMPLE SOLUTIONS PSYCHOTHERAPY

    Case Manager

    3 weeks ago

    SIMPLE SOLUTIONS PSYCHOTHERAPY Rancho Cucamonga, United States

    Job Description · Job DescriptionJob Description: Our Case Manager manages caseloads for clients and is responsible for coordinating and managing healthcare and wellness services and resources for clients. This role involves liaising with healthcare providers, clients, and other ...

  • SIMPLE SOLUTIONS PSYCHOTHERAPY

    Case Manager

    2 weeks ago

    SIMPLE SOLUTIONS PSYCHOTHERAPY Rancho Cucamonga, United States

    Job Description · Job DescriptionBenefits:401(k) matching · Dental insurance · Flexible schedule · Free food & snacks · Health insurance · Paid time off · Job Description: Our Case Manager manages caseloads for clients and is responsible for coordinating and managing healthcare a ...

  • Kaiser Permanente

    Senior Case Manager

    1 week ago

    Kaiser Permanente Rancho Cucamonga, United States

    Job Summary: · Position located within the Correspondence center, reporting to the Correspondence Center Team Lead or Correspondence Center Assistant Director. Responsible for handling grievances and appeals review process through investigation, preparation, effectuation, and pre ...

  • Care Navigators On Demand

    Director, Case Management

    3 weeks ago

    Care Navigators On Demand Rancho Cucamonga, United States

    Full time | Care Navigators On Demand | United States · Posted On 08/21/2019 · Job Information · Industry · Health Care · City · State/Province · California · Zip/Postal Code · 90501 · Job Description · Job Duties: · Provides leadership and management of clinical care coordin ...

  • Marsell Wellness Center

    Case Manager

    2 weeks ago

    Marsell Wellness Center Ontario, United States

    Job Description · Job DescriptionJOB description · Job Title:Case ManagerDepartment: · Location:Family Wellness · OntarioReports To:Lead Case ManagerFLSA Status: · Salary: Non-Exempt · Starting at $27.40 · Position Summary: The Case Manager will perform a full range of targeted a ...

  • Randstad

    case manager

    2 days ago

    Randstad Rancho Cucamonga, United States

    case manager. · rancho cucamonga , california · posted 5 days ago · job details · summary · $ $40.54 per hour · contract · high school · category computer and mathematical occupations · reference · job details · job summary: · Participate in managing the organization's com ...

  • Randstad

    case manager

    5 days ago

    Randstad Rancho Cucamonga, United States

    case manager. · rancho cucamonga , california · posted 2 days ago · job details · summary · $ $40.54 per hour · contract · high school · category computer and mathematical occupations · reference · job details · job summary: · Participate in managing the organization's com ...

  • Innova Solutions

    Case Manager

    1 week ago

    Innova Solutions Rancho Cucamonga, United States

    Innova Solutions is immediately hiring for aCase Manager · Position Type: Full-time · Client ID: · Duration: 12 months + · Location: Rancho Cucamonga, CA Onsite ) · As a Case Manager>you will: · Participate in managing the organization's complaint and grievance process. A ...

  • Medical Solutions

    Travel Case Management

    15 hours ago

    Medical Solutions Ontario, United States

    $ $ wk (includes wage of ~$28.60-$35.36/hr and per diems if eligible) · click for benefits and other job details · ~$ $ weekly taxable income · ~$1316 in non-taxable per diem (amount subject to eligibility & seasonal/annual adjustment) · Calling all healthcare rockstars Are you a ...

  • SIMPLE SOLUTIONS PSYCHOTHERAPY

    Case Manager

    3 weeks ago

    SIMPLE SOLUTIONS PSYCHOTHERAPY Rancho Cucamonga, United States

    Benefits: · 401(k) matching · Dental insurance · Flexible schedule · Free food & snacks · Health insurance · Paid time off · Job Description: Our Case Manager manages caseloads for clients and is responsible for coordinating and managing healthcare and wellness services an ...

  • Innova Solutions

    Case Manager

    1 week ago

    Innova Solutions Rancho Cucamonga, United States

    Innova Solutions is immediately hiring for a Case Manager · Position Type: Full-time · Client ID: · Duration: 12 months + · Location: Rancho Cucamonga, CA Onsite ) · As a Case Manager>you will: · Participate in managing the organization's complaint and grievance process. ...

  • AMN Healthcare

    RN Case Manager

    2 days ago

    AMN Healthcare Ontario, United States

    Job Description & Requirements · RN Case Manager · StartDate: 6/10/2024 Pay Rate: $ $3300.00 · POSITION SUMMARY RN Case Manager · POSITION DUTIES DCP in an acute care setting; 1-2 years experience; · MINIMUM REQUIRED QUALIFICATIONS DCP in an acute care setting; 1-2 years experien ...

  • Medical Solutions

    Travel Case Management

    1 day ago

    Medical Solutions Ontario, United States

    $ $ wk (includes wage of ~$28.60-$35.36/hr and per diems if eligible) · click for benefits and other job details · ~$ $ weekly taxable income · ~$1316 in non-taxable per diem (amount subject to eligibility & seasonal/annual adjustment) · You've spun your compass and landed here A ...

  • AMN Healthcare

    RN Case Manager

    2 days ago

    AMN Healthcare Ontario, United States

    POSITION SUMMARY RN Case Manager · POSITION DUTIES DCP in an acute care setting; 1-2 years experience; · MINIMUM REQUIRED QUALIFICATIONS DCP in an acute care setting; 1-2 years experience · PREFERRED QUALIFICATIONS Kaiser experience · LENGTH OF ASSIGNMENT 13 weeks · SHIFT / HOURS ...

  • Medical Solutions

    Travel Case Management

    1 day ago

    Medical Solutions Ontario, United States

    $ $ wk (includes wage of ~$28.60-$35.36/hr and per diems if eligible) · click for benefits and other job details · ~$ $ weekly taxable income · ~$1316 in non-taxable per diem (amount subject to eligibility & seasonal/annual adjustment) · Are you ready to choose your next adventur ...

  • CorVel Corporation

    CA Medical Case Manager II

    3 weeks ago

    CorVel Corporation Rancho Cucamonga, United States Full time

    CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Rancho Cucamonga, CA. · Work from home, and on the road. Monday – Friday, regular business hours. · As a Medical Case Manager you will ma ...

  • The Great Greek Mediterranean Grill

    Case Manager

    2 weeks ago

    The Great Greek Mediterranean Grill Rancho Cucamonga, United States

    Currently seeking a Catering Sales Associate You will be part of a team that works to provide full-service catering. You will manage events of all types and sizes, for both existing and new clientele. You will cultivate new client relationships, maintain existing relationships, a ...

  • Jameco Home Health Agency Inc.

    LVN Case Manager

    2 weeks ago

    Jameco Home Health Agency Inc. Upland, United States

    Job Description · Job DescriptionThe Case Manager is typically an LVN with ensuring that patient care is coordinated and managed appropriately; · Case Managment is incharge ofstaffing and plotting visits for SN (skilled nurses), MSW, CHHA, call patients after SOC/RECERT/ROC, Assi ...

  • Pacific Clinics

    Crisis Case Manager

    3 weeks ago

    Pacific Clinics Upland, United States

    Who We Are · The Neurodevelopmental Services program uses the power of interpersonal neurobiology, trauma-informed care, and neurodiversity-affirming practices to provide treatment, training, and research with neurodivergent and disabled communities. · Our goal is to impact to ne ...