- Coordinates and reviews all medical records, as assigned to caseload
- Actively participates in Case Management and Treatment Team meetings
- Serves as on-going educator to all departments
- Responsible for reviewing patient charts in order to assess whether the criteria for admission and continuation of treatment is being met; gathering data and responding to request for records from fiscal intermediary; gathering clinical and fiscal information and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting
- Able to work independently and use sound judgment.
- Knowledge of Federal, State, and intermediary guidelines related to inpatient, acute care hospitalization, as well as lower levels of care for the continuity of treatment.
- Coordinates discharge referrals as requested by clinical staff, fiscal intermediary, patients, and families.
- Performs other duties as assigned.
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Lvn Utilization Review
2 weeks ago
MemorialCare Medical Foundation Fountain Valley, United States**LVN Utilization Review** · - (MEM007924) · **Description** · **Title**:LVN Utilization Review · **Location**: Fountain Valley · **Department**: Outpatient Utilization Management · **Status**: Per-diem · **Shift**: Days · **Pay Range**:$34.79/hour - $50.42/hour · At MemorialCare ...
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quality review lvn
2 weeks ago
Hoag Memorial Hospital Presbyterian Newport Beach, CA, United StatesSalary Range: $ $49.64 /hour. Actual compensation may vary based on geographic location, work experience, skill level, and education. · Primary Duties and Responsibilities · The Quality Review Nurse is a professional, licensed vocational nurse responsible for analyzing data integ ...
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LVN Utilization Review
2 weeks ago
MemorialCare Fountain Valley, United States· Title: LVN Utilization Review · Location: Fountain Valley · Department: Outpatient Utilization Management · Status: Per-diem · Shift: Days · Pay Range*: $40.00/hour · At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities ...
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Case Manager
2 weeks ago
HALLWAY HEALTHCARE INC. Corona, United States**We are looking for a Part Time RN Case Manager to join our team** · **WORK FROM HOME with exception of patient appointments (done every 6 months) and occasional home visit check ins.** · **Hallway Healthcare** provides in-home nursing care to retired Nuclear and Federal Workers ...
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Manager, Utilization Management
2 weeks ago
Optum Corona, United StatesFor those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start **Caring. Connecting. Growing together.** · Optum's Pacific West region is redefining ...
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Traveler Case Manager
1 week ago
Diverse Lynx LCC Riverside, United States**About us** · We are professional, agile, professional and our goal is to promote and support a diverse workforce at all levels in the company.. · Our work environment includes: · - Modern office setting · - Food provided · - Growth opportunities · **LVN Case Manager needed. Day ...
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Quality Assurance Nurse
1 week ago
Riverside PostAcute Care Riverside, United States***: · The Clinical Quality Assurance Nurse reviews cases and ensures all necessary information has been provided and is accurate before sending back to requestor. The Clinical Quality Assurance Nurse will also oversee the facility's policies and procedures. · **RESPONSIBILITIES/ ...
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Lvn Supervisor Ii
4 days ago
Telecare Corporation Riverside, United StatesTelecare's mission is to deliver excellent and effective behavioral health services that engage individuals in recovering their health, hopes, and dreams. Telecare continues to advance cultural diversity, humility, equity, and inclusion at all levels of our organization by hiring ...
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Lpn/lvn- Full Time
1 week ago
Riverside Medical Clinic Riverside, United States Full time**Responsibilities**: · **Come and join the RMC Family** · We have been in the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our missi ...
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Specialty Unit Charge Rn
2 weeks ago
Kaiser Permanente Riverside, United States**Job Summary**: · Functions as a Lead of the healthcare team, coordinates departmental operations that ensure quality patient care in a safe, healing environment that is patient and family centered. Demonstrates responsibility and accountability for own professional practice. Ha ...
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LVN-Home Health/Hospice/Palliative Care
6 days ago
Kaiser Riverside, United States Full timeJob Summary: · Provides nursing care to patients under the direction of a Registered Nurse utilizes observational skills to assess nursing intervention and assists medical staff to insure optimal patient care within established policies, procedures and standards. · Essential Res ...
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Head of Services
1 week ago
West Covina Foster Family Agency Chino, United StatesThe Head of Service (HOS) works as the primary clinical supervisor of up to two STRTP. The HOS is primarily responsible for all clinical functions to ensure that treatment continuity is maintained for students and their families. · **DUTIES AND RESPONSIBLITIES** · - Maintaining a ...
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Provider/field Assistant
2 weeks ago
Omni Wound Physicians Ontario, United States**ESSENTIAL DUTIES AND RESPONSIBILITIES INCLUDES** · - Relays any communication from the Provider to the Office which includes but not limited to treatment orders, antibiotic orders, complications, complaints, requests from patient/nurses/providers, updates on ETA and others · - ...
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Integrated Transitional Care Nurse, Lvn
3 days ago
Inland Empire Health Plan Rancho Cucamonga, United States**What you can expect** · Find joy in serving others with IEHP We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an **authentic experience** · Join the dynamic Integrated transitional Care team, directed by our visionar ...
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Integrated Transitional Care Nurse, Lvn
3 days ago
Inland Empire Health Plan Rancho Cucamonga, United StatesOverview: · **What you can expect** · Find joy in serving others with IEHP We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an **authentic experience** · Join the dynamic Integrated transitional Care team, directed by ...
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Case Manager Lvn
2 weeks ago
San Antonio Regional Hospital Upland, United StatesOverview: · **JOB SUMMARY** · Evaluates the clinical status of patients using evidence based criteria to determine medical necessity for hospitalization, clinical progression and continued acute care needs. Utilizes information about clinical condition, prior level of functioning ...
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Lvn Runner/field Nurse
2 weeks ago
AH/SH/WH-HOSPICES Murrieta, United States_LVN Field Nurse / Hospice Experience_ · We are looking for a Hospice experienced Licensed Vocational · You will be responsible for managing all aspects of the patient intake process including managing the members of the intake team, · establishing and maintaining positive relati ...
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Program Manager
3 days ago
Akua Behavioral Health Costa Mesa, United States**Position**: Program Manager · **Type/Shift**: Salaried, Full-Time, Exempt · **Compensation** · - Base Salary: $90,000 - $100,000 · - Performance Bonus: Up to $500 per week · - Employee Ownership Shares (ESOP) · - Benefits: Health Insurance, PTO & Sick Leave, Educational Stipend ...
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Program Manager
2 weeks ago
Akua Behavioral Health Costa Mesa, United States**Position**: Program Manager · **Type/Shift**: Salaried, Full-Time, Exempt · **Compensation** · - Base Salary: $80,000 - $90,000 · - Performance Bonus: Up to $26,000 · - Employee Ownership Shares (ESOP) · - Benefits: Health Insurance, PTO & Sick Leave, Educational Stipend · The ...
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Lvn I
1 week ago
City of Hope Upland, United States**LVN I** · Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope's growing national system includes its Los Angeles campus, a network of clin ...