Jobs
>
Long Beach

    Utilization Review Coordinator - Long Beach, United States - COLLABORATIVE NEUROSCIENCE NETWORK LLC

    COLLABORATIVE NEUROSCIENCE NETWORK LLC
    COLLABORATIVE NEUROSCIENCE NETWORK LLC Long Beach, United States

    1 week ago

    Default job background
    Description

    Job Description

    Job Description

    Facility Overview

    At Ocean View Psychiatric Health Facility, we are committed to serving as a community resource, providing the highest quality of mental health services. Currently, Ocean View operates as an adult 39-bed voluntary acute in-patient facility, offering private rooms and individualized care through a multi-disciplinary approach focusing on compassionate care and best practices. We also provide Intensive Outpatient and Partial hospitalization services to ensure a continuum of care after acute stabilization. We are currently in the process of expanding our Long Beach facility to 80 beds, offering a locked facility setting for those who meet intensive mental health criteria. Additionally, our expansion plans to other areas are progressing rapidly, and we anticipate that our Colton Location in San Bernadino County, will be operational by Summer of 2024.

    Utilization Review Coordinator Position Overview

    Pay: $25 - $30 / Hour

    Ocean View Utilization Review Coordinator in our psychiatric health facility plays a crucial role and is responsible for evaluating the necessity, appropriateness, and efficiency of the use of medical services, including inpatient psychiatric care. UR Coordinator works closely with healthcare providers, insurance companies, and patients to ensure that treatment plans align with medical necessity criteria and regulatory guidelines. As a member of the Utilization Review Committee, the employee is responsible for reviewing Patient charts and assessing the hospital use of professional care, services, and procedures.

    This includes the medical necessity and appropriateness of:

    • Patient admission; re-admission
    • Level of care
    • Utilization of resources
    • Continued hospital stays and corresponding documentation
    • Discharge and post hospital care referrals
    • Quality improvement
    • Insurance coordination
    • Compliance
    • Interdisciplinary Collaboration
    • Multiple admissions

    The UR Coordinator will also report findings related to patterns and trends of over-utilization and under-utilization and excessive resource use. Compiles monthly reports and statistics for presentation to the Utilization Review Committee. Works with UR Committee to establish interventions to prevent or resolve utilization problems and to improve systems and processes associated with inefficient or inappropriate delivery of care or services.

    Make a difference by providing quality care alongside us at Ocean View

    Minimum Qualifications

    • 2 years of experience in Utilization Review or related position in a healthcare setting.
    • Ability to interact and communicate verbally and in writing with seriously and persistently mentally ill Patients, other staff members, and the public.
    • Ability to speak, read, and write legibly in English.

    Preferred Qualifications

    • AA degree or bachelor's degree
    • Bilingual English/Spanish +.
    • Must speak fluent English. Excellent verbal and written communication as well as strong interpersonal and organizational skills required.
    • Medical Records certification preferred.
    • Previous JCAHO experience preferred.

    Special Conditions

    Job offer is contingent on successful engagement in our COVID-19 vaccination program (documented proof of being fully vaccinated with 1 booster), live scan fingerprinting/background check clearance, and license/education verification.

  • COLLABORATIVE NEUROSCIENCE NETWORK LLC

    Utilization Review Coordinator

    1 week ago

    COLLABORATIVE NEUROSCIENCE NETWORK LLC Long Beach, United States

    **Facility Overview** · At Ocean View Psychiatric Health Facility, we are committed to serving as a community resource, providing the highest quality of mental health services. Currently, Ocean View operates as an adult 39-bed voluntary acute in-patient facility, offering private ...

  • Collaborative NeuroScience Network

    Utilization Review Coordinator

    2 weeks ago

    Collaborative NeuroScience Network Long Beach, United States

    Job Description · Job Description · Facility Overview · At Ocean View Psychiatric Health Facility, we are committed to serving as a community resource, providing the highest quality of mental health services. Currently, Ocean View operates as an adult 39-bed voluntary acute in- ...

  • Kastel Staffing

    Claims Review Coordinator

    4 days ago

    Kastel Staffing Los Angeles, United States

    POSITION TITLE · Claims Review Coordinator · REPORTS TO · Assistant Manager, Claims & Appeals · JOB SUMMARY · The Claims Review Coordinator is responsible for the investigation, documentation and resolution of denied claims in compliance with State/Federal law, rules, and gu ...

  • Long Beach Unified School District

    Information Technology Project Coordinator

    1 week ago

    Long Beach Unified School District Long Beach, United States

    **JOB SUMMARY** · Under general supervision, plan, coordinate and oversee information systems technology projects District-wide; develop project budgets; monitor and evaluate the progress of projects; collect data, conduct studies and prepare reports; perform related duties as as ...

  • Advanced Medical Management, Inc.

    Claims Examiner Iii

    1 week ago

    Advanced Medical Management, Inc. Long Beach, United States

    **Claims Examiner III** · **Role Insights** · **Primary Responsibilities** · - Audit claims processing quality, develops, maintains and runs standard reports · - Assist the Claims Supervisor/Director in reviewing the quality auditing tracking/reporting (financial and procedural) ...

  • SCAN Health Plan

    Payroll Administrator

    5 days ago

    SCAN Health Plan Long Beach, United States

    **Mostly Onsite (2-3 days a week) in Long Beach, CA** · **About SCAN** · **The Job** · The Payroll Administrator is responsible for processing payroll in a multi-state and multi-company environment, performing audits on time keeping records and other payroll data, providing backu ...

  • TekWissenLLC

    Safety Analyst

    2 weeks ago

    TekWissenLLC Long Beach, United States

    This position supports the client Vehicle Processing & Distribution Center (VDC) Safety and Environmental program requirements. · - Activities include but are not limited to: · - Identify, anticipate, and act upon safety and environmental concerns, hazards, exposures, and unsafe ...

  • TruCare Community

    Community Liaison for Assisted Living Facility in

    1 week ago

    TruCare Community Long Beach, United States

    **Community Liaison/Office Assistant (Full-Time, AM shifts)** · **_ $250 Sign On Bonus_** · Villa Redondo Care is an assisted living facility for the elderly community located in Downtown Long Beach. We are currently seeking a compassionate and dependable Community Liaison** **wh ...

  • TruCare Community

    Community Liaison/marketer for Assisted Living

    23 hours ago

    TruCare Community Long Beach, United States

    **Community Liaison (Full-Time, AM shifts)** · **_ $250 Sign On Bonus_** · Villa Redondo Care is an assisted living facility for the elderly community located in Downtown Long Beach. We are currently seeking a compassionate and dependable Community Liaison** **who has a passion t ...

  • Curtin Maritime

    Dredge Captain

    5 days ago

    Curtin Maritime Long Beach, United States

    **Position**:Dredge Captain · **Location**:Varies · **Department**:Operations · **Reports to**:VP of Dredging · **Schedule**:Full-time, 4 Weeks On/4 Weeks Off · - Efficiency. Innovation. Integrity. These are our 3 Pillars. At Curtin Maritime, these core values are the framework f ...

  • Molina Healthcare

    Enterprise Crisis Response Manager

    4 days ago

    Molina Healthcare Long Beach, United States

    Job Description · Job Summary · This role is not a IT-focused Security Operations (SOC) threat monitoring, incident identification and investigation activity. This role will support the overall cyber response program, which is heavily focused on business response and fully integr ...

  • Molina Healthcare

    Crisis Response Manager

    2 hours ago

    Molina Healthcare Long Beach, United States

    Job Description · Job Summary · The Cyber Response Manager will be primarily responsible for day-to-day delivery of cyber response /crisis management program activities, including providing guidance and consultation to employees across the enterprise to ensure compliance. Support ...

  • Airgas

    Customer Contract Specialist

    1 week ago

    Airgas Long Beach, United States

    R Customer Contract Specialist (Open) · **Location**: · Long Beach, CA - Management - West BSC · How will you CONTRIBUTE and GROW? · Responsible for specializing in the effective execution, drafting, and management of customer contracts. Reporting to the Customer Contract Manager ...

  • Dannis Woliver Kelley

    Legal Secretary

    2 hours ago

    Dannis Woliver Kelley Long Beach, United States

    **Essential duties and responsibilities include**: · - Prepare documents including correspondence, memoranda and legal documents; compose and draft routine cover letters and shell documents · - Prepare and process court and administrative agency filings, as well as maintain and r ...

  • Molina Healthcare

    Care Review Processor

    1 week ago

    Molina Healthcare Long Beach, United States

    Job Summary · Molina Healthcare Services (HCS) 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 ne ...

  • Kallen Contracting Inc.

    Construction Superintendent

    1 week ago

    Kallen Contracting Inc. Long Beach, United States

    **Overview**: · Under management supervision, superintendents will plan, coordinate, and supervise new construction and remodeling of existing buildings. · **Responsibilities**: · 1. Organizes, coordinates, and supervises the work of the Foreman, Sub-Foreman, and/or craft employe ...

  • Molina Healthcare

    Care Review Clinician, Inpatient Review

    23 hours ago

    Molina Healthcare Long Beach, United States

    For this position it will be helpful to have previous experience in Acute Care, Concurrent Review/ Utilization Review / Utilization Management and prior knowledge of Interqual / MCG guidelines. Basic knowledge of Utilization Management processes desired. COMPACT LICENSURE IS REQU ...

  • Molina Healthcare

    Care Review Clinician, Inpatient Review

    2 hours ago

    Molina Healthcare Long Beach, United States

    **JOB TITLE**: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSE · For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. ...

  • Molina Healthcare

    Care Review Clinician, Inpatient Review

    1 week ago

    Molina Healthcare Long Beach, United States

    **JOB TITLE**: CARE REVIEW CLINICIAN INPATIENT REVIEW : REGISTERED NURSE · For this position we are seeking a (RN) Registered Nurse with previous experience in Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. ...

  • Molina Healthcare

    Care Review Clinician, Inpatient Review

    1 week ago

    Molina Healthcare Long Beach, United States

    For this position we are seeking a California (RN) Registered Nurse with 3 years+ Concurrent Review/ Utilization Review / Utilization Management and must have Interqual, and MCG guidelines experience. CURRENT RN CALIFORNIA LICENSURE IS REQUIRED FOR THIS POSITION. California is no ...