Unfortunately, this job posting is expired.
Don't worry, we can still help! Below, please find related information to help you with your job search.
Don't worry, we can still help! Below, please find related information to help you with your job search.
Related keywords
- South San Diego Patient Services Representative
- Gaming Artist At San Diego Ca
- Lvn Needed In Garberville Ca
- San Diego Business Development Manager
- County Auditor
- Professional Consulting Veterinarian In San Diego
- San Diego Veteran Job Fair
- San Diego Home Caregiver – Weekends
- Lvn Lpn
- Optometrist – San Diego
Some similar recruitments
Travel Nurse Rn - Er/Trauma - $2,367 Per Week In Temecula, Ca
Recruited by TravelNurseSource 7 months ago
Address Temecula, CA, United States
Travel Nurse Rn - Er/Trauma - $2,411 Per Week In Sonora, Ca
Recruited by TravelNurseSource 7 months ago
Address Sonora, CA, United States
Travel Nurse Rn - Telemetry - $2,422 To $2,600 Per Week In Santa Clara, Ca
Recruited by TravelNurseSource 7 months ago
Address Santa Clara, CA, United States
Research Assistant - San Diego
Recruited by Headlands Research 7 months ago
Address San Diego, CA, United States
Travel Nurse Rn - Er/Trauma - $2,646 Per Week In Temecula, Ca
Recruited by TravelNurseSource 7 months ago
Address Temecula, CA, United States
Full-Time (35 - 40 Hrs) - Security Guard - Naval Base San Diego
Recruited by NAVY EXCHANGE SERVICE COMMAND (NEXCOM) 7 months ago
Address San Diego, CA, United States
Travel Nurse Rn - Or - $3,160 Per Week In San Diego, Ca
Recruited by TravelNurseSource 7 months ago
Address San Diego, CA, United States
Travel Nurse Rn - Case Manager - $2,733 Per Week In San Leandro, Ca
Recruited by TravelNurseSource 7 months ago
Address San Leandro, CA, United States
Travel Nurse Rn - Or - $2,737 To $3,035 Per Week In San Diego, Ca
Recruited by TravelNurseSource 7 months ago
Address San Diego, CA, United States
Project Coordinator (Healthcare) In Onsite In Palo Alto, Ca
Recruited by Sonitalent Corp 7 months ago
Address Palo Alto, CA, United States
Store Manager - San Leandro
Recruited by Pet Food Express 7 months ago
Address San Leandro, CA, United States
Travel Nurse Rn - Or - $2,125 To $2,349 Per Week In National City, Ca
Recruited by TravelNurseSource 7 months ago
Address National City, CA, United States
Travel Nurse Rn - Or - $3,250 Per Week In Novato, Ca
Recruited by TravelNurseSource 7 months ago
Address Novato, CA, United States
Recruitment Assistant /Human Resources (San Diego)
Recruited by Whova 7 months ago
Address San Diego, CA, United States
Travel Nurse Rn - Or - $2,701 Per Week In La Jolla, Ca
Recruited by TravelNurseSource 7 months ago
Address San Diego, CA, United States
Travel Nurse Rn - $2,740 Per Week In Modesto, Ca
Recruited by TravelNurseSource 7 months ago
Address Modesto, CA, United States
Travel Nurse Rn - $2,120 To $2,273 Per Week In King City, Ca
Recruited by TravelNurseSource 7 months ago
Address King City, CA, United States
Travel Nurse Rn - Cvor - $3,150 To $3,482 Per Week In Redding, Ca
Recruited by TravelNurseSource 7 months ago
Address Redding, CA, United States
Travel Nurse Rn - Or - $2,613 To $2,888 Per Week In Fresno, Ca
Recruited by TravelNurseSource 7 months ago
Address Fresno, CA, United States
Volunteer: Projectionist - San Diego Int'l Film Festival
Recruited by VolunteerMatch 7 months ago
Address San Diego, CA, United States
Travel Rehab Job In Downey, Ca - Make $760 - $960/Week
Recruited by Aya Healthcare 7 months ago
Address Downey, CA, United States
Travel Nurse Rn - $2,508 To $2,780 Per Week In Irvine, Ca
Recruited by TravelNurseSource 7 months ago
Address Irvine, CA, United States
Parts Driver- Jaguar Land Rover San Diego
Recruited by Holman 7 months ago
Address San Diego, CA, United States
Clinical Services Auditor (Lvn/ Lpn): Travel Required In San Diego County Ca
Company | Molina Healthcare |
Address | , San Diego |
Employment type | FULL_TIME |
Salary | $21.82 - $42.55 an hour |
Expires | 2023-09-21 |
Posted at | 8 months ago |
We are seeking LVN Nurse Auditors for this role, THIS POSITION REQUIRES 50% TRAVEL BY CAR (2 - 3 days a week in the field), throughout the area that you are responsible for. The qualified candidate MUST BE LOCATED CURRENTLY IN SAN DIEGO COUNTY, CALIFORNIA. Travel will include but may not be limited to San Diego County, and Los Angeles County. Multiple openings will be available. A clean DMV driving record, proof of auto insurance, and reliable transportation is required. Must be able to do your own driving. Mileage will be reimbursed. Position will be based from your remote home office in California.
KNOWLEDGE/SKILLS/ABILITIES
Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM) and monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May also perform non-clinical system and process audits, as needed.
Audits for clinical gaps in care from a medical and/or behavioral perspective to ensure member needs are being met.
Assesses clinical staff regarding appropriate clinical decision-making.
Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings leadership.
Ensures auditing approaches follow a Molina standard in approach and tool use.
Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and professionalism with all communications.
Adheres to departmental standards, policies, protocols.
Maintains detailed records of auditing results.
Assists HCS training team with developing training materials or job aids as needed to address findings in audit results.
Meets minimum production standards
May conduct staff trainings as needed
Communicates with QA supervisor/manager about issues identified and works collaboratively to resolve/correct them.
15% travel required.
JOB QUALIFICATIONS
Required Education
Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program and/or Associate's or bachelor’s degree in Health related field.
Required Experience
Minimum two years UM, CM, MAT, HM, DM, and/or managed care experience.
Proficient knowledge of Molina workflows.
Required License, Certification, Association
Active, unrestricted State Licensed Vocational Nurse or Practical Nurse (LVN or LPN) in good standing.
Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
Preferred Experience
More than one-year managed care experience. One year of UM, CM, DM auditing experience.
Pay Range: $21.82 - $42.55 an hour*
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
KNOWLEDGE/SKILLS/ABILITIES
Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM) and monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May also perform non-clinical system and process audits, as needed.
Audits for clinical gaps in care from a medical and/or behavioral perspective to ensure member needs are being met.
Assesses clinical staff regarding appropriate clinical decision-making.
Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings leadership.
Ensures auditing approaches follow a Molina standard in approach and tool use.
Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and professionalism with all communications.
Adheres to departmental standards, policies, protocols.
Maintains detailed records of auditing results.
Assists HCS training team with developing training materials or job aids as needed to address findings in audit results.
Meets minimum production standards
May conduct staff trainings as needed
Communicates with QA supervisor/manager about issues identified and works collaboratively to resolve/correct them.
15% travel required.
JOB QUALIFICATIONS
Required Education
Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program and/or Associate's or bachelor’s degree in Health related field.
Required Experience
Minimum two years UM, CM, MAT, HM, DM, and/or managed care experience.
Proficient knowledge of Molina workflows.
Required License, Certification, Association
Active, unrestricted State Licensed Vocational Nurse or Practical Nurse (LVN or LPN) in good standing.
Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
Preferred Experience
More than one-year managed care experience. One year of UM, CM, DM auditing experience.
Pay Range: $21.82 - $42.55 an hour*
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
-
Systems Analyst - Excel, Xml, Sql, Scripting
By CyberCoders At Salt Lake City, UT, United States 7 months ago
-
(Senior) Finance & Shared Services Manager
By Catholics For Choice At Washington, DC, United States 7 months ago
-
Paralegal - Probate Administration
By CyberCoders At Miami, FL, United States 7 months ago
-
Account Executive - Automotive Software
By ECW Search At United States 7 months ago
-
Construction Project Coordinator Jobs
By CyberCoders At River Falls, WI, United States 7 months ago