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The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) throughout admission and performs concurrent reviews/retrospective reviews according to guidelines.
$46.92 - $77.43 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Identifies possible coding deficiencies through charge/medical record review and coordinates coding review to ensure accurate charge capture, maximizing third-party reimbursement and minimizing audit liability.
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Prepares draft audit reports for the review and approval of the Audit Manager and Chief Internal Auditor. Prepares Exit Grid with findings and recommendations for the review and approval of the Audit Manager and Chief Internal Auditor.
$110,000 - $135,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Initial review of EEOC and state agency charges and conferring with the AGC on a strategy to defend all charges. From time to time, the Litigation Counsel may provide broader advice to company management as a member of the legal team.
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The SM is responsible for ensuring that a thorough estimate review is conducted with the project Estimator and Bid Captain during project alignment meetings to ensure alignment on bid strategy, labor strategy and equipment resource plans.
$120,000 - $150,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.
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License, Certification, RegistrationRegistered Nurse License (California)Basic Life SupportAdditional Requirements:Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of Utilization review/management, discharge planning or case management.
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Oversight responsibility for all regulatory body surveys, such as, JCAHO, State Licensing Review, HCFA (CMS) Validation surveys. ScionHealth - Kindred Cornerstone & Solara Hospitals is seeking a Registered Nurse (RN) Quality Assurance Director for a nursing job in La Puente, California.
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Create/modify documentation in support of reviews associated with formal testing, which may include Test Readiness Review (TRR), Consent to Ship (CTS), and Test Data Review (TDR) packages.
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Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of utilization review/management, care coordination, transfer coordination, discharge planning or case management.
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Participates in pharmacokinetics and antibiotic review activities. Current CA State Board of Pharmacy Intern Pharmacist License. Participates in pharmacokinetics and antibiotic review activities.
$18.25 an hourInternExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Prefer prior experience in case management, utilization review, or discharge planning. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies.
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Review data for acceptance criteria against specification ranges and report results in LIMS and to laboratory management. Great opportunity to gain experience as a QC Chemist in the pharmaceutical industry.
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Funds loans and provides basic credit review counseling for members with declined loans. including but not limited to Trusts, Estates, Power of Attorneys and Notary Public services. If you are applying for a Hybrid/Remote position, pleasenoteapplicants are required to reside within ourWescomservice areas which are defined as the following counties: Los Angeles, Orange, San Bernardino, Riverside, Ventura, Santa Barbara, San Diego, Imperial ,Fresno, Kern, Kings, Madera, Merced, Mariposa, Monterey, San Benito, San Joaquin, San Luis Obispo, Santa Cruz, Stanislaus and Tulare counties.
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Review and interpret new and proposed environmental laws and regulations, and guide managementPerform environmental compliance and due diligence audits to ensure compliance with all applicable regulatory agencies.
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review job in Pico Rivera, CA
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