Talent.com
Ohio Licensed Patient Care Manager

Ohio Licensed Patient Care Manager

VirtualVocationsMission Viejo, California, United States
5 hours ago
Job type
  • Full-time
Job description

A company is looking for a Patient Care Resource Manager - Retrospective Review.

Key Responsibilities

Conduct retrospective reviews of medical services to assess medical necessity and compliance with guidelines

Support the Utilization Management team with prior authorizations and concurrent reviews

Analyze claims data to identify trends and develop action plans for process improvements

Required Qualifications

Bachelor's degree in nursing and a current Ohio Registered Nurse license

Minimum of three years' experience in a clinical setting, with a focus on utilization or case management

Knowledge of managed health care concepts and experience with national guidelines (e.g., MCG)

Proficiency in Microsoft Office applications and electronic health records

Strong understanding of HIPAA regulations and compliance requirements

Create a job alert for this search

Patient Care Manager • Mission Viejo, California, United States

Related jobs
  • Promoted
Healthcare Industry Success Leader

Healthcare Industry Success Leader

VirtualVocationsOceanside, California, United States
Full-time
A company is looking for an Industry Success Leader (HCLS).Key Responsibilities Serve as a Consulting Leader, leveraging domain expertise to improve client business outcomes Own and develop a bo...Show moreLast updated: 1 day ago
  • Promoted
Kentucky Licensed Care Manager

Kentucky Licensed Care Manager

VirtualVocationsHuntington Beach, California, United States
Full-time
A company is looking for a Care Manager (RN) to develop and facilitate care management activities for members with physical needs. Key Responsibilities Evaluate member needs and recommend care pla...Show moreLast updated: 30+ days ago
  • Promoted
State Licensed Behavioral Health Director

State Licensed Behavioral Health Director

VirtualVocationsOntario, California, United States
Full-time
A company is looking for a Senior Director, Utilization Management - Behavioral Health.Key Responsibilities Lead and oversee behavioral health management within the utilization management organiz...Show moreLast updated: 1 day ago
  • Promoted
Delaware Licensed Medical Director

Delaware Licensed Medical Director

VirtualVocationsOceanside, California, United States
Full-time
A company is looking for a Medical Director for long term care.Key Responsibilities Ensure outstanding medical care and optimal health outcomes for residents Provide direct patient care while ov...Show moreLast updated: 1 day ago
  • Promoted
Medical Director - Arizona Licensed

Medical Director - Arizona Licensed

VirtualVocationsOceanside, California, United States
Full-time
A company is looking for a Clinical Advocacy and Support Medical Director, Internist, Surgery or Plastic Surgery Preferred - Remote. Key Responsibilities Conduct coverage reviews based on individu...Show moreLast updated: 30+ days ago
  • Promoted
Clinical Supervisor

Clinical Supervisor

Crittenton Services for Children and FamiliesNorwalk, CA, United States
Full-time
Oversee clinical services to all clients and coordinate with various department staff as well as program contracted / affiliated agencies. Work involves managing Wraparound, IFCCS and CBSL staff membe...Show moreLast updated: 30+ days ago
  • Promoted
Registered Nurse Manager

Registered Nurse Manager

VirtualVocationsCorona, California, United States
Full-time
A company is looking for a Care Navigation Nurse Manager to provide strategic and operational leadership to their Care Navigation team. Key Responsibilities Oversee daily operations of the Care Na...Show moreLast updated: 5 days ago
  • Promoted
Licensed Clinical Supervisor

Licensed Clinical Supervisor

VirtualVocationsOceanside, California, United States
Full-time
A company is looking for a Supervisor, Clinical Administration - Remote.Key Responsibilities Provide leadership to a team of clinicians supporting membership in multiple facets of care Guide and...Show moreLast updated: 30+ days ago
  • Promoted
Senior Manager Clinical Biomarkers

Senior Manager Clinical Biomarkers

VirtualVocationsOceanside, California, United States
Full-time
A company is looking for a Senior Manager of Clinical Biomarkers.Key Responsibilities Lead the development and execution of clinical biomarker plans aligned with clinical development strategy Ov...Show moreLast updated: 1 day ago
  • Promoted
Pennsylvania Licensed Care Manager Supervisor

Pennsylvania Licensed Care Manager Supervisor

VirtualVocationsOceanside, California, United States
Full-time
A company is looking for a Professional Care Manager, Supervisor (RN).Key Responsibilities Oversee care coordination functions for clinical staff, including supervision, coaching, and counseling ...Show moreLast updated: 2 days ago
  • Promoted
Behavioral Health Care Manager, Licensed (Contract)

Behavioral Health Care Manager, Licensed (Contract)

IEHPRancho Cucamonga, CA, United States
Full-time
This position is a temporary role facilitated through one of our contracted agencies and is not a direct employment opportunity with IEHP. The contracted agency offers an assignment length of up to ...Show moreLast updated: 13 days ago
  • Promoted
Mississippi Licensed Care Manager

Mississippi Licensed Care Manager

VirtualVocationsFontana, California, United States
Full-time
A company is looking for a Care Manager (RN) to develop and facilitate complex care management activities for members with physical needs. Key Responsibilities Evaluate member needs and recommend ...Show moreLast updated: 30+ days ago
  • Promoted
Pennsylvania Licensed Care Manager

Pennsylvania Licensed Care Manager

VirtualVocationsNorwalk, California, United States
Full-time
A company is looking for a Care Manager.Key Responsibilities Conduct telephone assessments to determine care coordination and management needs Develop care plans to help members achieve optimal ...Show moreLast updated: 30+ days ago
  • Promoted
  • New!
New Jersey Licensed Behavioral Health Manager

New Jersey Licensed Behavioral Health Manager

VirtualVocationsOceanside, California, United States
Full-time
A company is looking for a Behavioral Health Care Manager.Key Responsibilities Makes timely intensity of services determinations or refers to higher-level review when indicated Provides linkage ...Show moreLast updated: 13 hours ago
  • Promoted
Charge Nurse-Cath Lab

Charge Nurse-Cath Lab

Loma Linda University HealthMurrieta, CA, United States
Full-time
Cath Lab Department (Full-time, Day Shift).The Charge Nurse-Cath Lab demonstrates advance competency in nursing related to the specialty practice of cardiac disease and cardiac diagnostic testing a...Show moreLast updated: 30+ days ago
  • Promoted
Healthcare Credentialing Coordinator

Healthcare Credentialing Coordinator

VirtualVocationsOceanside, California, United States
Full-time
A company is looking for a Healthcare Credentialing Coordinator - Part-Time - Remote.Key Responsibilities Manage the full lifecycle of the credentialing and re-credentialing process for healthcar...Show moreLast updated: 2 days ago
  • Promoted
RN Denials Management Associate Manager

RN Denials Management Associate Manager

VirtualVocationsOceanside, California, United States
Full-time
A company is looking for an Associate Manager RN Denials Management.Key Responsibilities Oversee operations of the team to ensure efficient payer denial and appeal reviews Supervise team members...Show moreLast updated: 1 day ago
  • Promoted
Care Manager

Care Manager

Sunrise Senior LivingOrange, CA, US
Full-time
When you join Sunrise Senior Living, you will be able to use your unique skills to empower residents to live longer, healthier, and happier lives. Not only will you build meaningful relationships wi...Show moreLast updated: 30+ days ago
  • Promoted
Supervisor of Nursing - SICU

Supervisor of Nursing - SICU

WEBCO HR, IncMission Viejo, CA, US
Full-time
SUPERVISOR NURSING - SICU -MISSION VIEJO, CALIFORNIA.Supervisor of Nursing - SICU for one of our clients located in Mission Viejo, California. This is a Full Time, 3 Nights - 12-hourshift position.T...Show moreLast updated: 8 days ago
  • Promoted
Senior Clinical Coordinator

Senior Clinical Coordinator

VirtualVocationsOceanside, California, United States
Full-time
A company is looking for a Senior Clinical Administrative Coordinator.Key Responsibilities Act as a Subject Matter Expert for team members Manage the intake of members with benefit reviews and i...Show moreLast updated: 30+ days ago