- Sharp HealthCare (San Diego, CA)
- …+ Experience as a case manager or discharge planner interacting with managed care payers. + Experience with InterQual or Milliman Guidelines. **Essential ... Start Time** **Shift End Time** California Licensed Vocational Nurse ( LVN ) - CA Board of Vocational Nursing & Psychiatric...and current standards of clinical practice. + Knowledge of managed care and Health Plan contracts. +… more
- Sharp HealthCare (San Diego, CA)
- …credibility with physicians and non-physician health care practitioners involved in case management + California Licensed Vocational Nurse ( LVN ) - CA Board ... utilizes strategies to manage length of stay and resource utilization within case managed patients populations.Assists the department in identifying causes of… more
- Molina Healthcare (Fort Worth, TX)
- …with disabilities/chronic conditions and Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or ... behavioral health settings. **PREFERRED EXPERIENCE:** + 3-5 years in case management, disease management, managed care or medical or behavioral health… more
- Prime Healthcare (Ontario, CA)
- …in discharge planning/utilization management/ case management terminology and functions, in both managed care and non- managed care environments.2. ... education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/164261/ case -management-discharge-planner- lvn /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare Management Inc… more
- LA Care Health Plan (Los Angeles, CA)
- …Utilization Management/ Case Management experience in a hospital or HMO setting. Preferred: Managed Care experience performing UM and CM at a medical group or ... Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management...$87,342.00 (Mid.) - $107,498.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created… more
- Dignity Health (Santa Maria, CA)
- …Home Health experience **Special Skills:** + Demonstrates ability to work within a case - managed model of patient- care delivery. + Demonstrates proficient ... the Nation by Healthgrades and was awarded Best Maternity Care by Newsweek. It ranks among 10% in the...and an array of womens services. **Responsibilities** The Staff LVN is a practitioner who demonstrates in-depth knowledge of… more
- Prime Healthcare (Inglewood, CA)
- …in discharge planning/utilization management/ case management terminology and functions, in both managed care and non- managed care environments.2. ... nationally for quality and patient safety, Centinela Hospital is a 362-bed acute- care hospital with a 24-hour STEMI certified emergency department and primary stroke… more
- Molina Healthcare (Brooklyn, NY)
- … review/utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), case management, transition of care , health management ... 3 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management. + Minimum 2 years of… more
- Skyline Nursing Center (Dallas, TX)
- …staff, resident, and/or responsible party. * Attends weekly Medicare, Medicaid and Managed Care meetings as required. * Corrects and ensures completion ... work of the heart. To provide the best resident care , we promote a culture that is both employee...instructs staff in the RAI Process, PPS Medicare, Medicaid ( Case Mix as required) and clinical computer system in… more
- Diversicare Healthcare Services & Diversicare Ther (Houston, TX)
- …(ie: certifications, denial letters, skilled documentation, coverage criteria, etc ) 15. Provides Managed Care case management at the center level. 16. ... of the patient/resident. 3. Coordinates and conducts the daily Case Management meeting. 4. Ensures timely MDS assessments according...19. Continues to update knowledge base related to Medicare, Managed Care , Medicaid, RAI Process and computer… more
- LA Care Health Plan (Los Angeles, CA)
- Managed Long Term Services and Supports Nurse Specialist RN...in direct patient care , such as ambulatory care , home care , or case management. ... with individuals with chronic illnesses, comorbidities, and/or disabilities in a case / care management environment. Preferred: Experience in utilization review,… more
- Molina Healthcare (Bronx, NY)
- …with disabilities/chronic conditions and Long-Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or ... behavioral health settings. **PREFERRED EXPERIENCE:** + **3-5 years in case management, disease management, managed care or medical or behavioral health… more
- Molina Healthcare (Detroit, MI)
- …with disabilities/chronic conditions and Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or ... behavioral health settings. **PREFERRED EXPERIENCE:** + 3-5 years in case management, disease management, managed care or medical or behavioral health… more
- Molina Healthcare (Richmond, TX)
- …with disabilities/chronic conditions and Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or ... behavioral health settings. **PREFERRED EXPERIENCE:** + 3-5 years in case management, disease management, managed care or medical or behavioral health… more
- Molina Healthcare (Anderson, SC)
- …gerontology, public health or social work or related **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or ... a minimum of one year of professional experience. **PREFERRED EXPERIENCE:** 3-5 years in case management, disease management, managed care or medical or… more
- Molina Healthcare (Vancouver, WA)
- …gerontology, public health or social work or related **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or ... a minimum of one year of professional experience. **PREFERRED EXPERIENCE:** 3-5 years in case management, disease management, managed care or medical or… more
- Molina Healthcare (Richmond, VA)
- …gerontology, public health or social work or related **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or ... a minimum of one year of professional experience. **PREFERRED EXPERIENCE:** 3-5 years in case management, disease management, managed care or medical or… more
- Horizon Services, Inc. (San Mateo, CA)
- …+ Maintain positive working relationships with community providers and managed care organizations. + Assist with case management training at monthly staff ... care and discharge planning, and crisis intervention. The case manager will collaborate frequently with Program and Personnel...Manager, Detox Program Counselor and Medical Staff (referring to LVN , EMT) to ensure clients basic needs are being… more
- Molina Healthcare (Tacoma, WA)
- …psychology, gerontology, public health or social work. **Required Experience** + 1-3 years in case management, disease management, managed care or medical or ... applicable state or locality with reliable transportation. **Preferred Experience** 3-5 years in case management, disease management, managed care or medical… more
- Molina Healthcare (Charleston, SC)
- …related case management experience. **Required Experience** 3 or more years in case management, disease management, managed care or medical or behavioral ... illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** Oversees an integrated Care Management team responsible for case management, community… more