Nursing Jobs in El Segundo, CA

RN Full-time
Molina Healthcare

RN Care Manager (Telephonic Case Management) - Remote in Nebraska

apartment Molina Healthcare location_onLong Beach, CA
JOB DESCRIPTION Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. • Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. • Conducts telephonic, face-to-face or home visits as required. • Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Maintains ongoing member caseload for regular outreach and management. • Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. • Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care, provides care coordination and assistance to member to address concerns. • May provide consultation, resources and recommendations to peers as needed. • Care manager RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct medication reconciliation as needed. • 15% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). • Demonstrated knowledge of community resources. • Ability to operate proactively and demonstrate detail-oriented work. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and self-motivation. • Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications • Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V #PJHS #LI-AC1 Pay Range: $25.08 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
RN Contract
Prime Healthcare

Registered Nurse, RN - Case Manager

apartment Prime Healthcare location_onInglewood, CA
Overview Centinela Hospital Medical Center has been serving the communities of Inglewood and the wider Los Angeles area for nearly 100 years. An award-winning facility, ranking in the top 5% nationally for quality and patient safety, Centinela Hospital is a 362-bed acute-care hospital with a 24-hour emergency department and primary stroke center, orthopedic care, advanced cardiac services, critical care services, robotics surgery program, inpatient and outpatient rehab programs, labor and delivery, and more. Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Why Prime Healthcare? Centinela Hospital Medical Center; a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Celebrating Our Centinela Hospital Heroes Centinela has earned hundreds of national awards and recognitions, including "100 Top Hospital" recognition from Fortune/Merative and straight 'A's (2018-2022) for hospital safety from The Leapfrog Group. For more information, visit www.centinelamed.com. Centinela Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to: Paid Time Off 401K retirement plan Outstanding Medical Dental Vision Coverage Tuition Reimbursement Many more Voluntary Benefit Options! Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. A current California State Registered Nurse (RN) license is required. 2. Five years acute care nursing experience preferred. 3. At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS (AHA) certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic to intermediate computer skills. To speak to a recruiter schedule a time to speak : https://calendly.com/bnuno-primehealthcare/rn-case-manager Pay Transparency Centinela Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $59.07 to $59.07. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure. Employment Status Per Diem Shift Days Equal Employment Opportunity Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf Privacy Notice Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf
RN Med-Surg Full-time
Dignity St. Mary Medical Center

RN Medical Surgical

apartment Dignity St. Mary Medical Center location_onLong Beach, CA
Job Summary and Responsibilities As a Medical Surgical Nurse at St Mary Medical Center, you’ll excel in your nursing career by providing care to patients admitted to our unit. Most of your patients are funneled in from other units providing you with the opportunity to build on your education and experience in specialized service lines such as cardiac, telemetry, orthopedics, neurology, critical care, surgical services, and emergency. Your success in this role comes from your enthusiasm to help others - with a patient-first mindset. Keen assessment skills, critical thinking, and a sense of urgency support your career advancement and you thrive in a fast-paced clinical environment where you will rarely experience the same day twice. While you’re busy impacting the healthcare industry, we’ll take care of you with benefits that include health/dental/vision, FSA, matching retirement plans, paid vacation, adoption assistance, and more. Responsibilities Except to deliver care to 4-6 patients per shift Administer medications, change dressings, monitor vital signs, and chart with timely documentation Collaborate with a variety of other healthcare professionals such as social work, care coordination, physical therapy, occupational therapy, lab, respiratory therapy, and imaging If you are committed to social justice, health equity, and prepared to deliver care in new, innovative ways, you belong with us. #RN@DH Job Requirements Current licensure as a Registered Nurse in the State of California. Current basic life support (BLS) certification. Minimum of one year Acute Care RN experience. Where You'll Work CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S., from clinics and hospitals to home-based care and virtual care services, CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen, both inside our hospitals and out in the community. One Community. One Mission. One California
RN Pediatric Full-time
East Tennessee Children's Hospital

Registered Nurse (RN) Pre/Post, Full Time, Dayshift (80)

apartment East Tennessee Children's Hospital location_onBeverly Hills, CA
BASIC PURPOSE OF THE JOB Manages individualized, goal-directed nursing care through use of the nursing process and the principles of primary nursing in accordance with departmental and hospital policies and procedures. REPORTS TO Nurse Manager JOB REQUIREMENTS Supervisory Responsibilities: NO Minimum Education: Bachelors or Associates of Nursing Required Degree: Nursing License/Certification Required: Nursing Licensure for State of Tennessee Minimum Work Experience: Pediatric nursing experience preferred. REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES Excellent communication and customer service skills. Demonstrated clinical abilities. DUTIES AND RESPONSIBILITIES Collects comprehensive data pertinent to the healthcare needs of patients and formulates nursing diagnoses based on the analysis of that assessment data, and documents data in a concise and timely manner. Develops and follows a plan of care that prescribes interventions to attain expected outcomes. Identifies expected outcomes for the plan of care individualized to the child, family, and situation. Implements and coordinates the delivery of care while employing strategies to promote health and a safe environment. Evaluates progress toward the attainment of outcomes. Systematically evaluates the quality and effectiveness of nursing practice. Collaborates with the family in the conduct of nursing practice. All decisions and actions are on behalf of the patient and family and in all areas of practice are determined in an ethical manner. Integrates research findings into practice and, where appropriate, participates in the generation of new knowledge in innovative ways. Interacts with and contributes to the professional development of peers and colleagues. Serves as a leader in the practice setting and in the profession. Acquires and maintains current knowledge and competency in nursing practice. Considers factors related to safety, effectiveness, cost and impact on practice in planning and delivering care. PHYSICAL REQUIREMENTS-Note: Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position. Heavy lifting, pushing, and pulling is required up to 50 lbs occasionally, 20-30 lbs frequently, and 10lbs constantly to move objects of up to 150 lbs. Sudden emergency situations have the potential for exposure to lifting or moving of up to 150 lbs. Frequent bending, walking, sitting squatting, reaching, and standing are required. Keyboard/computer use and/or repetitive motions may be required. Come work where you can make a difference everyday.
Surgical Tech OR Pediatric Full-time
East Tennessee Children's Hospital

Certified Surgical Tech (CST), Operating Room, Full Time, Dayshift

apartment East Tennessee Children's Hospital location_onBeverly Hills, CA
BASIC PURPOSE OF THE JOB A specially trained individual who helps prepare for surgical patients by selecting and preparing the supplies and instruments. Assists the surgeon under the direct supervision of a Registered Nurse. Performs transport duties within the perioperative departments. REPORTS TO Nurse Manager/Nursing Director JOB REQUIREMENTS Supervisory Responsibilities: No Minimum Education: High School/GED; Graduate of an approved Operating Room Technician program required Degree: General License/Certification Required: Certified Surgical Technician; BLS required Minimum Work Experience: Operating Room experience preferred REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES Excellent attention to detail and good at following verbal instructions. DUTIES AND RESPONSIBILITIES Demonstrates proficient understanding of sterilization processes, steam, gas and cold and its impact on various instruments and equipment by providing mechanism to identify what type of sterilization is necessary on existing and new instruments. Researches and Reports abnormalities of instruments and equipment that facilitates the running of the unit to the OR Director and/or other appropriate individuals, and sends instruments and equipment out for repair following all guidelines, maintaining a record of what is out and when the items will be returned. Provides literature or necessary interventions on equipment specific sterilization when appropriate. Reviews case cart set ups daily in a thorough manner to detect accuracy and completeness. Transports patients by stretcher, wheelchair or other conveyance from pre/post operative locations. Responsible for monitoring and responding to patients and families during transportation phase. Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment. Assures staff competency by creating and providing training. Offers constructive suggestions at staff meetings for utilization of equipment, repair of equipment and proper care of equipment. Informs staff and others of improper use or abuse of equipment and recommends solutions. Demonstrates positive regard for change and problems. Attends all required meetings, demonstrates safety and maintains their work area and equipment by expected standard. Promotes effective working relations and works effectively as part of a department/unit team inter- and intra-departmentally to facilitate the department’s/unit’s ability to meet its goals and objectives. Fosters mature professional relationships with fellow employees in a courteous, friendly, manner as measured by management observation and peer input. Keeps accurate documentation of equipment brought into and taken out of the department. Utilizes hospital resources and time respectfully and accountably and willingly accepts any other assignment that may be requested. PHYSICAL REQUIREMENTS Note: Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position. Medium lifting, pushing and pulling is required for 20-50 lbs occasionally, 10-20 pounds frequently and 10 lbs constantly to move objects. Sudden emergency situations have the potential for exposure for lifting or moving of up to 100 lbs. Frequent bending, walking, sitting, squatting, reaching, and standing are required. Keyboard/computer use and/or repetitive motions may be required. Come work where you can make a difference everyday.
Caregiver Full-time
Always Best Care of Thousand Oaks

Caregivers

apartment Always Best Care of Thousand Oaks location_onAgoura Hills, CA
Always Best Care is a TOP Senior Care Agency in the area, AND WE WANT YOU! We are immediately hiring reliable Caregivers/CNAs for our Assisted Living Communities and private in home clients in Ventura County. We also hire those who are new to caregiving, pay will depend on experience! ASSISTED LIVING EXPERIENCE A PLUS- We specialize in Senior Care- WE PAY YOU FOR YOUR TRAINING! SHIFTS AVAILABLE IN THE FOLLOWING CITIES: SANTA PAULA, GRANADA HILLS, FILLMOR,E, VENTURA, OXNARD, CAMARILLO, THOUSAND OAKS, NEWBURY PARK, WESTLAKE VILLAGE, MOORPARK, SIMI VALLEY, AGOURA HILLS, OJAI, CALABASAS, WOODLAND HILLS, WINNETKA, SYLMAR. Pay Rate: $19-$25/per hour DOE AND CLIENT NEEDS.
Caregiver Full-time
SYNERGY HomeCare of Chatsworth

Caregiver

apartment SYNERGY HomeCare of Chatsworth location_onLos Angeles, CA
Experience the SYNERGY HomeCare difference, where we are united under one purpose, to bring wholehearted, life-energizing care to as many people as possible - on their terms, in their own homes. And that starts with compassionate Caregivers like YOU! When you join the SYNERGY HomeCare team as a Caregiver, you will feel appreciated, recognized, and rewarded for the comforting, life-affirming care that comes right from your heart! Our promise to our clients is to bring full support for fuller lives and to elevate their confidence, knowing they have a Caregiver like you by their side. Do you: Enjoy serving others? Have a big heart with a lot of love to share? Take charge with a warm smile? We always have an opening for Caregivers who can answer yes to these questions. At SYNERGY HomeCare, we create a world of care at home for all, which means as a Caregiver, you will have the opportunity to care for a diverse range of people, spanning all ages and abilities. We are seeking Caregivers to join our independently owned and operated national agency. SYNERGY HomeCare offers Caregivers: Competitive pay: $20–$25/hour, depending on position & experience Over time and holiday pay Bonuses for employee & client referrals Exceptional training and support programs for career growth, leading to a pay increase Fill-in (on-call) shift coverage benefits Flexible schedules and matching you with nearby clients Part-time employment opportunities Mileage reimbursement (client transportation and between same-day visits) Participation in employee opinion surveys Liability and Workers' Compensation coverage Supportive office team and employee recognition programs As a Caregiver with SYNERGY HomeCare, you will: Provide attention to clients’ non-medical needs, including companionship and social engagement Assist clients with activities of daily living, such as bathing, dressing, grooming, and toileting Provide clients with medication reminders Support clients with mobility challenges and assist with lifting when required Assist the client with light housekeeping, meal preparation, and laundry Establish communication and a professional relationship with clients, family members, and co-workers Provide reliable care by being punctual and consistently covering shifts Requirements: Current Home Care Aide (HCA) Registration with the State of California (Or ability to obtain) and passed your live scan background check, and be listed as Active Proof of current TB testing (Or ability to obtain) Must be physically able to perform the functions of this position Have reliable transportation, a valid driver's license, and proof of sufficient automobile insurance (when applicable) CNA, CPR, and First Aid certifications are not required, but a plus If you would like to join our outstanding team at SYNERGY HomeCare, apply today!
Caregiver Full-time
Right at Home Calabasas

Join A Warm Team Of Caregivers

apartment Right at Home Calabasas location_onLos Angeles, CA
Job Summary: Join our Sherman Oaks caregiving team and enjoy local clients, flexible shifts, and professional support every step of the way. What We Offer: • Flexible Schedules (Shifts Can Be Arranged To Fit Your Availability) • Bi-Weekly Pay • Mobile Clock In/Out • Access to Paycheck Advances • Serve Seniors Close to Home — in Your Own Community • Paid Travel Time & Mileage Between Clients • Ongoing Paid Training & Development • Positive Work Environment with Celebrations & Recognition • Leadership Development Opportunities • Meaningful Relationships That Make a Real Difference What You’ll Do and Who You Are: At Right at Home Calabasas, we believe caregivers are the heart of our business. If you're looking for more than just a job, but a purposeful career, this is for you. • Honest, dependable, and compassionate • A great communicator who can connect easily with clients and families • Adaptable, reliable, and calm under pressure • Accountable and always take pride in your work • Professional and respectful in your appearance and interactions • Dedicated to client dignity and comfort Responsibilities: • Assist with personal care & daily living activities • Provide companionship & emotional support • Light housekeeping & errands • Prepare meals & snacks • Medication reminders Qualifications (Must Haves): • At least 1 year of paid professional caregiving experience • Valid California Driver’s License and reliable transportation • Active California Home Care Aide (HCA) number • Authorized to work in the U.S. • Able to pass DOJ & FBI background check • Negative TB test or clear chest X-ray • Basic computer skills Additional Requirements : • California HCA registration (or willingness to obtain) • 1+ year caregiving experience preferred • Reliable transportation • Background check & TB clearance required Apply today and join our Sherman Oaks caregiving team! Keywords: caregiver jobs Sherman Oaks, senior care 91423, home care aide Sherman Oaks, caregiver with flexible hours
LVN Full-time
Lynwood Healthcare Center

Licensed Vocational Nurse LVN

apartment Lynwood Healthcare Center location_onLynwood, CA
Prioritizing PM shift (3-11pm) POSITION SUMMARY The purpose of your job position is to provide each resident with routine daily nursing care in accordance with current federal, state, and local standards that govern the facility and as directed by your supervisors. The Licensed Vocational Nurse will treat each resident with kindness, dignity and respect. They will knock before entering each resident’s room. They will refer to each resident by their name. They will be courteous to families and visitors. They will maintain a positive and calm disposition. They will communicate clearly, empathetically, and effectively when speaking to residents, family members, visitors, staff and any governmental agency personnel. They will make sound independent decisions when circumstances warrant such action. They will work cooperatively with all departments and multidisciplinary teams. They will demonstrate patience, initiative and willingness to assist residents that may be difficult. They will relate all pertinent information concerning a resident’s condition to a charge nurse when required. They will be committed to always doing the right thing. ESSENTIAL DUTIES AND RESPONSIBILITIES Ensuring that all nursing care is provided in privacy Checking vital signs Dressing wounds Inserting catheters Listening to residents and their families Addressing questions/concerns of residents Performing accurate and detailed charting of resident progress notes Timely reporting of change in resident’s condition to the nurse supervisor Assisting and supervising CNAs Ensuring equipment is in good operating order Monitoring residents that are at risk for falls Collecting lab samples Abiding with all facility policies and procedures including not disclosing user ID codes and passwords Following Infection and Control policies Reporting any occupational exposures to blood, body fluids, or other hazardous materials to a supervisor immediately Attending annual facility in-service training programs Completing other assignments when requested by management Every effort has been made to identify the essential functions of this position. However, it in no way states or implies these are the only duties you will be required to perform as directed by management. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position. REQUIREMENTS Education / Licensure Completion of LVN training from accredited school or college Valid LVN license in good standing Valid CPR and BLS card IV Certification is a plus Qualifications / Experience Minimum of 1 year of skilled nursing experience preferred Must be able to speak, read, write and comprehend the English language Ability to use computer or tablet to enter resident data Working Conditions May encounter frequent interruptions May be involved with residents, family and government agencies May be requested to work beyond scheduled working hours at times Is subject to call-back during emergency conditions (e.g., severe weather, evacuation, post-disaster, etc.) May be subjected to odors, dust, disinfectants, tobacco smoking or air contaminants May be exposed to infectious waste, diseases, conditions, etc., including TB and the AIDS and Hepatitis B viruses May be exposed to or handle hazardous chemicals Physical Requirements Must be able to move intermittently throughout the day Working throughout the nursing areas Must be able to lift up to 25 pounds. Lifting more weight up to 100 pounds requires assistance Ability to read fine print on tablet, progress notes and/or medical labels
Caregiver Part-time
Right at Home Westside

Caregiver Needed in Brentwood – 8 to 10 Hour Shifts (Male Preferred)

apartment Right at Home Westside location_onCA
Immediate openings for Male Caregivers! Want to join a company that truly makes a difference in the world? Are you ready to serve a population that needs you right now? We stand prepared to equip you with the proper personal protective equipment (PPE) and are ready to assist as you care for our vulnerable population of seniors and adults with disabilities. By joining the Right at Home-Westside team, you will have the unique opportunity to improve the quality of life for those you serve by working for one of the fastest-growing international home care companies with over 25 years of experience. Available shifts: 8-to-10-hour shifts, (Sunday through Wednesday) Responsibilities will include helping with transfers in and out of bed, chair, and other necessary locations. Assistance with ADLs (Activities of Daily Living), including help with grooming and other basic needs, will also be necessary. Experience with physical therapy is required, as the caregiver will need to assist with daily exercises and rehabilitation. The ideal candidate will have a friendly, outgoing personality and be able to work effectively under pressure. Patience and empathy are vital qualities needed for success in this role. Benefits Here’s Why Caregivers Like Working for Right at Home: Earn competitive pay Flexible scheduling Health Insurance Plans Employee Discount Programs Bonuses for employee referrals PAID training and development Caregiver Recognition & Rewards Programs Access to Leadership Paid travel time in between clients plus mileage reimbursement Bi-Weekly Pay Mobile clock in /out Make a difference and give back to those who need your most Qualifications and Skills: High school graduate or G.E.D. certificate preferred. Must be able to lift/move 50 lbs without assistance Ability to read, write, speak, and understand English as needed for the job Possess a valid driver’s license and current automobile insurance Pass a background check Home Care Aide registration preferred Right at Home is committed to ensuring equal employment opportunities for all individuals, regardless of race, color, religion, sex, national origin, disability, protected veteran status, sexual orientation, gender identity, or any other legally protected basis, per applicable law.
CNA Full-time
Always Best Care of Thousand Oaks

Certified Nursing Assistant (CNA)

apartment Always Best Care of Thousand Oaks location_onAgoura Hills, CA
Always Best Care is a TOP Senior Care Agency in the area, AND WE WANT YOU! We are immediately hiring reliable Caregivers/CNAs for our Assisted Living Communities and private in home clients in Ventura County. We also hire those who are new to caregiving, pay will depend on experience! ASSISTED LIVING EXPERIENCE A PLUS- We specialize in Senior Care- WE PAY YOU FOR YOUR TRAINING! SHIFTS AVAILABLE IN THE FOLLOWING CITIES: SANTA PAULA, GRANADA HILLS, FILLMOR,E, VENTURA, OXNARD, CAMARILLO, THOUSAND OAKS, NEWBURY PARK, WESTLAKE VILLAGE, MOORPARK, SIMI VALLEY, AGOURA HILLS, OJAI, CALABASAS, WOODLAND HILLS, WINNETKA, SYLMAR.
Caregiver Full-time
Right at Home Calabasas

A Rewarding Path As A Caregiver

apartment Right at Home Calabasas location_onHidden Hills, CA
Job Summary: In Hidden Hills, caregiving means more than just tasks — it’s about building trust and offering comfort to seniors in beautiful home settings. What We Offer: • Flexible Schedules (Shifts Can Be Arranged To Fit Your Availability) • Bi-Weekly Pay • Mobile Clock In/Out • Access to Paycheck Advances • Serve Seniors Close to Home — in Your Own Community • Paid Travel Time & Mileage Between Clients • Ongoing Paid Training & Development • Positive Work Environment with Celebrations & Recognition • Leadership Development Opportunities • Meaningful Relationships That Make a Real Difference What You’ll Do and Who You Are: At Right at Home Calabasas, we believe caregivers are the heart of our business. If you're looking for more than just a job, but a purposeful career, this is for you. • Honest, dependable, and compassionate • A great communicator who can connect easily with clients and families • Adaptable, reliable, and calm under pressure • Accountable and always take pride in your work • Professional and respectful in your appearance and interactions • Dedicated to client dignity and comfort Responsibilities: • Assist with personal care & daily living activities • Provide companionship & emotional support • Light housekeeping & errands • Prepare meals & snacks • Medication reminders Qualifications (Must Haves): • At least 1 year of paid professional caregiving experience • Valid California Driver’s License and reliable transportation • Active California Home Care Aide (HCA) number • Authorized to work in the U.S. • Able to pass DOJ & FBI background check • Negative TB test or clear chest X-ray • Basic computer skills Additional Requirements : • California HCA registration (or willingness to obtain) • 1+ year caregiving experience preferred • Reliable transportation • Background check & TB clearance required Apply today and start serving Hidden Hills seniors! Keywords: caregiver jobs Hidden Hills, senior care 91302, home care aide Hidden Hills, caregiver flexible schedule
RN Utilization Review Full-time
Molina Healthcare

Medical Review Nurse (RN)

apartment Molina Healthcare location_onLong Beach, CA
Job Description Job Summary Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. Job Duties Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made, or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. Reevaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of relevant and applicable state and federal regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions. Validates member medical records and claims submitted/correct coding, to ensure appropriate reimbursement to providers. Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review including diagnosis-related group (DRG) validation, itemized bill review, appropriate level of care, inpatient readmission, and any opportunities identified by the payment integrity analytical team; makes decisions and recommendations pertinent to clinical experience. Prepares and presents cases representing Molina, along with the chief medical officer (CMO), for administrative law judge pre-hearings, state insurance commissions, and judicial fair hearings. Reviews medically appropriate clinical guidelines and other appropriate criteria with medical directors on denial decisions. Supplies criteria supporting all recommendations for denial or modification of payment decisions. Serves as a clinical resource for utilization management, CMOs, physicians and member/provider inquiries/appeals. Provides training and support to clinical peers. Identifies and refers members with special needs to the appropriate Molina program per applicable policies/protocols. Job Qualifications REQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice. Experience demonstrating knowledge of ICD-10, Current Procedural Technology (CPT) coding and Healthcare Common Procedure Coding (HCPC). Experience working within applicable state, federal, and third-party regulations. Analytic, problem-solving, and decision-making skills. Organizational and time-management skills. Attention to detail. Critical-thinking and active listening skills. Common look proficiency. Effective verbal and written communication skills. Microsoft Office suite and applicable software program(s) proficiency. PREFERRED QUALIFICATIONS: Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care certifications. Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics. Billing and coding experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $29.05 - $67.97 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
CNA Full-time
CHI Health

Certified Nursing Assistant

apartment CHI Health location_onLos Angeles, CA
Job Summary and Responsibilities As a Certified Nurse Assistant (CNA), you will be a cornerstone of patient care, directly contributing to comfort, safety, and recovery by providing essential support under RN direction. Every day, you will deliver compassionate basic care, assist with patient transport, and actively contribute to the patient's plan of care as a vital member of our interdisciplinary team, upholding the highest standards of conduct and patient well-being. To be successful in this role, you will possess a dedicated spirit of service, strong communication skills, a meticulous approach to patient support, and an unwavering commitment to our mission of dignified, high-quality healthcare. Provides personal hygiene care and assistance to patients in a timely manner and to document and report any unusual observation to the nurse in charge. Takes Vital Signs in a timely manner and reports abnormals promptly to the nurse in charge. Assists with food and fluid maintenance in a timely manner. Records Intake & Output consistently. Assists with elimination, documents according to prescribed procedures and reports patient's response in a timely and accurate manner. Assists in maintenance of body alignment, positioning and repositioning every 2 hours and PRN to provide patient comfort. Assists in pressure sore prevention by utilizing the turning schedule every 2 hours to patients with pressure sore or at risk of developing one. Job Requirements Required Certified Nursing Assistant: CA AHA Basic Life Support - CPR Fire Safety, within 90 Days of hire Preferred Certificate Other CNA training and education in an accredited CNA certification program Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Womens Health, obstetrics and pediatric services, and comprehensive cardiac and surgical services. The hospital shares a legacy of humankindness with Dignity Health, one of the nations five largest health care systems. Visit here https://www.dignityhealth.org/socal/locations/californiahospital for more information. One Community. One Mission. One California
CNA Full-time
CHI Health

Certified Nursing Assistant

apartment CHI Health location_onLos Angeles, CA
Job Summary and Responsibilities As a Certified Nurse Assistant (CNA), you will be a cornerstone of patient care, directly contributing to comfort, safety, and recovery by providing essential support under RN direction. Every day, you will deliver compassionate basic care, assist with patient transport, and actively contribute to the patient's plan of care as a vital member of our interdisciplinary team, upholding the highest standards of conduct and patient well-being. To be successful in this role, you will possess a dedicated spirit of service, strong communication skills, a meticulous approach to patient support, and an unwavering commitment to our mission of dignified, high-quality healthcare. Provides personal hygiene care and assistance to patients in a timely manner and to document and report any unusual observation to the nurse in charge. Takes Vital Signs in a timely manner and reports abnormals promptly to the nurse in charge. Assists with food and fluid maintenance in a timely manner. Records Intake & Output consistently. Assists with elimination, documents according to prescribed procedures and reports patient's response in a timely and accurate manner. Assists in maintenance of body alignment, positioning and repositioning every 2 hours and PRN to provide patient comfort. Assists in pressure sore prevention by utilizing the turning schedule every 2 hours to patients with pressure sore or at risk of developing one. Job Requirements Required Certified Nursing Assistant: CA AHA Basic Life Support - CPR Fire Safety, within 90 Days of hire Preferred CNA training and education in an accredited CNA certification program. Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Womens Health, obstetrics and pediatric services, and comprehensive cardiac and surgical services. The hospital shares a legacy of humankindness with Dignity Health, one of the nations five largest health care systems. Visit here https://www.dignityhealth.org/socal/locations/californiahospital for more information. One Community. One Mission. One California
CNA Full-time
Virginia Mason Franciscan Health

Certified Nursing Assistant

apartment Virginia Mason Franciscan Health location_onLos Angeles, CA
Job Summary and Responsibilities As a Certified Nurse Assistant (CNA), you will be a cornerstone of patient care, directly contributing to comfort, safety, and recovery by providing essential support under RN direction. Every day, you will deliver compassionate basic care, assist with patient transport, and actively contribute to the patient's plan of care as a vital member of our interdisciplinary team, upholding the highest standards of conduct and patient well-being. To be successful in this role, you will possess a dedicated spirit of service, strong communication skills, a meticulous approach to patient support, and an unwavering commitment to our mission of dignified, high-quality healthcare. Provides personal hygiene care and assistance to patients in a timely manner and to document and report any unusual observation to the nurse in charge. Takes Vital Signs in a timely manner and reports abnormals promptly to the nurse in charge. Assists with food and fluid maintenance in a timely manner. Records Intake & Output consistently. Assists with elimination, documents according to prescribed procedures and reports patient's response in a timely and accurate manner. Assists in maintenance of body alignment, positioning and repositioning every 2 hours and PRN to provide patient comfort. Assists in pressure sore prevention by utilizing the turning schedule every 2 hours to patients with pressure sore or at risk of developing one. Job Requirements Required Certified Nursing Assistant: CA AHA Basic Life Support - CPR Fire Safety, within 90 Days of hire Preferred CNA training and education in an accredited CNA certification program. Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Womens Health, obstetrics and pediatric services, and comprehensive cardiac and surgical services. The hospital shares a legacy of humankindness with Dignity Health, one of the nations five largest health care systems. Visit here https://www.dignityhealth.org/socal/locations/californiahospital for more information. One Community. One Mission. One California
CNA Full-time
CommonSpirit Health

Certified Nursing Assistant

apartment CommonSpirit Health location_onLos Angeles, CA
Job Summary and Responsibilities As a Certified Nurse Assistant (CNA), you will be a cornerstone of patient care, directly contributing to comfort, safety, and recovery by providing essential support under RN direction. Every day, you will deliver compassionate basic care, assist with patient transport, and actively contribute to the patient's plan of care as a vital member of our interdisciplinary team, upholding the highest standards of conduct and patient well-being. To be successful in this role, you will possess a dedicated spirit of service, strong communication skills, a meticulous approach to patient support, and an unwavering commitment to our mission of dignified, high-quality healthcare. Provides personal hygiene care and assistance to patients in a timely manner and to document and report any unusual observation to the nurse in charge. Takes Vital Signs in a timely manner and reports abnormals promptly to the nurse in charge. Assists with food and fluid maintenance in a timely manner. Records Intake & Output consistently. Assists with elimination, documents according to prescribed procedures and reports patient's response in a timely and accurate manner. Assists in maintenance of body alignment, positioning and repositioning every 2 hours and PRN to provide patient comfort. Assists in pressure sore prevention by utilizing the turning schedule every 2 hours to patients with pressure sore or at risk of developing one. Job Requirements Required Certified Nursing Assistant: CA AHA Basic Life Support - CPR Fire Safety, within 90 Days of hire Preferred CNA training and education in an accredited CNA certification program. Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Womens Health, obstetrics and pediatric services, and comprehensive cardiac and surgical services. The hospital shares a legacy of humankindness with Dignity Health, one of the nations five largest health care systems. Visit here https://www.dignityhealth.org/socal/locations/californiahospital for more information. One Community. One Mission. One California
CNA Full-time
Dignity St. Mary's Medical Center San Francisco

Certified Nursing Assistant

apartment Dignity St. Mary's Medical Center San Francisco location_onLos Angeles, CA
Job Summary and Responsibilities As a Certified Nurse Assistant (CNA), you will be a cornerstone of patient care, directly contributing to comfort, safety, and recovery by providing essential support under RN direction. Every day, you will deliver compassionate basic care, assist with patient transport, and actively contribute to the patient's plan of care as a vital member of our interdisciplinary team, upholding the highest standards of conduct and patient well-being. To be successful in this role, you will possess a dedicated spirit of service, strong communication skills, a meticulous approach to patient support, and an unwavering commitment to our mission of dignified, high-quality healthcare. Provides personal hygiene care and assistance to patients in a timely manner and to document and report any unusual observation to the nurse in charge. Takes Vital Signs in a timely manner and reports abnormals promptly to the nurse in charge. Assists with food and fluid maintenance in a timely manner. Records Intake & Output consistently. Assists with elimination, documents according to prescribed procedures and reports patient's response in a timely and accurate manner. Assists in maintenance of body alignment, positioning and repositioning every 2 hours and PRN to provide patient comfort. Assists in pressure sore prevention by utilizing the turning schedule every 2 hours to patients with pressure sore or at risk of developing one. Job Requirements Required Certified Nursing Assistant: CA AHA Basic Life Support - CPR Fire Safety, within 90 Days of hire Preferred CNA training and education in an accredited CNA certification program. Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Womens Health, obstetrics and pediatric services, and comprehensive cardiac and surgical services. The hospital shares a legacy of humankindness with Dignity Health, one of the nations five largest health care systems. Visit here https://www.dignityhealth.org/socal/locations/californiahospital for more information. One Community. One Mission. One California
CNA Full-time
Dignity Health

Certified Nursing Assistant

apartment Dignity Health location_onLos Angeles, CA
Job Summary and Responsibilities As a Certified Nurse Assistant (CNA), you will be a cornerstone of patient care, directly contributing to comfort, safety, and recovery by providing essential support under RN direction. Every day, you will deliver compassionate basic care, assist with patient transport, and actively contribute to the patient's plan of care as a vital member of our interdisciplinary team, upholding the highest standards of conduct and patient well-being. To be successful in this role, you will possess a dedicated spirit of service, strong communication skills, a meticulous approach to patient support, and an unwavering commitment to our mission of dignified, high-quality healthcare. Provides personal hygiene care and assistance to patients in a timely manner and to document and report any unusual observation to the nurse in charge. Takes Vital Signs in a timely manner and reports abnormals promptly to the nurse in charge. Assists with food and fluid maintenance in a timely manner. Records Intake & Output consistently. Assists with elimination, documents according to prescribed procedures and reports patient's response in a timely and accurate manner. Assists in maintenance of body alignment, positioning and repositioning every 2 hours and PRN to provide patient comfort. Assists in pressure sore prevention by utilizing the turning schedule every 2 hours to patients with pressure sore or at risk of developing one. Job Requirements Required Certified Nursing Assistant: CA AHA Basic Life Support - CPR Fire Safety, within 90 Days of hire Preferred CNA training and education in an accredited CNA certification program. Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Womens Health, obstetrics and pediatric services, and comprehensive cardiac and surgical services. The hospital shares a legacy of humankindness with Dignity Health, one of the nations five largest health care systems. Visit here https://www.dignityhealth.org/socal/locations/californiahospital for more information. One Community. One Mission. One California
CNA Full-time
Virginia Mason Franciscan Health

Certified Nursing Assistant

apartment Virginia Mason Franciscan Health location_onLos Angeles, CA
Job Summary and Responsibilities As a Certified Nurse Assistant (CNA), you will be a cornerstone of patient care, directly contributing to comfort, safety, and recovery by providing essential support under RN direction. Every day, you will deliver compassionate basic care, assist with patient transport, and actively contribute to the patient's plan of care as a vital member of our interdisciplinary team, upholding the highest standards of conduct and patient well-being. To be successful in this role, you will possess a dedicated spirit of service, strong communication skills, a meticulous approach to patient support, and an unwavering commitment to our mission of dignified, high-quality healthcare. Provides personal hygiene care and assistance to patients in a timely manner and to document and report any unusual observation to the nurse in charge. Takes Vital Signs in a timely manner and reports abnormals promptly to the nurse in charge. Assists with food and fluid maintenance in a timely manner. Records Intake & Output consistently. Assists with elimination, documents according to prescribed procedures and reports patient's response in a timely and accurate manner. Assists in maintenance of body alignment, positioning and repositioning every 2 hours and PRN to provide patient comfort. Assists in pressure sore prevention by utilizing the turning schedule every 2 hours to patients with pressure sore or at risk of developing one. Job Requirements Required Certified Nursing Assistant: CA AHA Basic Life Support - CPR Fire Safety, within 90 Days of hire Preferred Certificate Other CNA training and education in an accredited CNA certification program Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Womens Health, obstetrics and pediatric services, and comprehensive cardiac and surgical services. The hospital shares a legacy of humankindness with Dignity Health, one of the nations five largest health care systems. Visit here https://www.dignityhealth.org/socal/locations/californiahospital for more information. One Community. One Mission. One California
CNA Full-time
CommonSpirit Health

Certified Nursing Assistant

apartment CommonSpirit Health location_onLos Angeles, CA
Job Summary and Responsibilities As a Certified Nurse Assistant (CNA), you will be a cornerstone of patient care, directly contributing to comfort, safety, and recovery by providing essential support under RN direction. Every day, you will deliver compassionate basic care, assist with patient transport, and actively contribute to the patient's plan of care as a vital member of our interdisciplinary team, upholding the highest standards of conduct and patient well-being. To be successful in this role, you will possess a dedicated spirit of service, strong communication skills, a meticulous approach to patient support, and an unwavering commitment to our mission of dignified, high-quality healthcare. Provides personal hygiene care and assistance to patients in a timely manner and to document and report any unusual observation to the nurse in charge. Takes Vital Signs in a timely manner and reports abnormals promptly to the nurse in charge. Assists with food and fluid maintenance in a timely manner. Records Intake & Output consistently. Assists with elimination, documents according to prescribed procedures and reports patient's response in a timely and accurate manner. Assists in maintenance of body alignment, positioning and repositioning every 2 hours and PRN to provide patient comfort. Assists in pressure sore prevention by utilizing the turning schedule every 2 hours to patients with pressure sore or at risk of developing one. Job Requirements Required Certified Nursing Assistant: CA AHA Basic Life Support - CPR Fire Safety, within 90 Days of hire Preferred Certificate Other CNA training and education in an accredited CNA certification program Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Womens Health, obstetrics and pediatric services, and comprehensive cardiac and surgical services. The hospital shares a legacy of humankindness with Dignity Health, one of the nations five largest health care systems. Visit here https://www.dignityhealth.org/socal/locations/californiahospital for more information. One Community. One Mission. One California
CNA Full-time
Dignity St. Mary's Medical Center San Francisco

Certified Nursing Assistant

apartment Dignity St. Mary's Medical Center San Francisco location_onLos Angeles, CA
Job Summary and Responsibilities As a Certified Nurse Assistant (CNA), you will be a cornerstone of patient care, directly contributing to comfort, safety, and recovery by providing essential support under RN direction. Every day, you will deliver compassionate basic care, assist with patient transport, and actively contribute to the patient's plan of care as a vital member of our interdisciplinary team, upholding the highest standards of conduct and patient well-being. To be successful in this role, you will possess a dedicated spirit of service, strong communication skills, a meticulous approach to patient support, and an unwavering commitment to our mission of dignified, high-quality healthcare. Provides personal hygiene care and assistance to patients in a timely manner and to document and report any unusual observation to the nurse in charge. Takes Vital Signs in a timely manner and reports abnormals promptly to the nurse in charge. Assists with food and fluid maintenance in a timely manner. Records Intake & Output consistently. Assists with elimination, documents according to prescribed procedures and reports patient's response in a timely and accurate manner. Assists in maintenance of body alignment, positioning and repositioning every 2 hours and PRN to provide patient comfort. Assists in pressure sore prevention by utilizing the turning schedule every 2 hours to patients with pressure sore or at risk of developing one. Job Requirements Required Certified Nursing Assistant: CA AHA Basic Life Support - CPR Fire Safety, within 90 Days of hire Preferred Certificate Other CNA training and education in an accredited CNA certification program Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Womens Health, obstetrics and pediatric services, and comprehensive cardiac and surgical services. The hospital shares a legacy of humankindness with Dignity Health, one of the nations five largest health care systems. Visit here https://www.dignityhealth.org/socal/locations/californiahospital for more information. One Community. One Mission. One California
CNA Full-time
Dignity Health

Certified Nursing Assistant

apartment Dignity Health location_onLos Angeles, CA
Job Summary and Responsibilities As a Certified Nurse Assistant (CNA), you will be a cornerstone of patient care, directly contributing to comfort, safety, and recovery by providing essential support under RN direction. Every day, you will deliver compassionate basic care, assist with patient transport, and actively contribute to the patient's plan of care as a vital member of our interdisciplinary team, upholding the highest standards of conduct and patient well-being. To be successful in this role, you will possess a dedicated spirit of service, strong communication skills, a meticulous approach to patient support, and an unwavering commitment to our mission of dignified, high-quality healthcare. Provides personal hygiene care and assistance to patients in a timely manner and to document and report any unusual observation to the nurse in charge. Takes Vital Signs in a timely manner and reports abnormals promptly to the nurse in charge. Assists with food and fluid maintenance in a timely manner. Records Intake & Output consistently. Assists with elimination, documents according to prescribed procedures and reports patient's response in a timely and accurate manner. Assists in maintenance of body alignment, positioning and repositioning every 2 hours and PRN to provide patient comfort. Assists in pressure sore prevention by utilizing the turning schedule every 2 hours to patients with pressure sore or at risk of developing one. Job Requirements Required Certified Nursing Assistant: CA AHA Basic Life Support - CPR Fire Safety, within 90 Days of hire Preferred Certificate Other CNA training and education in an accredited CNA certification program Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including a Level II trauma center, the Los Angeles Center for Womens Health, obstetrics and pediatric services, and comprehensive cardiac and surgical services. The hospital shares a legacy of humankindness with Dignity Health, one of the nations five largest health care systems. Visit here https://www.dignityhealth.org/socal/locations/californiahospital for more information. One Community. One Mission. One California
RN Utilization Review Full-time
Molina Healthcare

Medical Review Nurse (RN) (Michigan Provider Post Appeals)

apartment Molina Healthcare location_onLong Beach, CA
Job Description Job Summary Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. Job Duties Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made, or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. Reevaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of relevant and applicable state and federal regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions. Validates member medical records and claims submitted/correct coding, to ensure appropriate reimbursement to providers. Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review including diagnosis-related group (DRG) validation, itemized bill review, appropriate level of care, inpatient readmission, and any opportunities identified by the payment integrity analytical team; makes decisions and recommendations pertinent to clinical experience. Prepares and presents cases representing Molina, along with the chief medical officer (CMO), for administrative law judge pre-hearings, state insurance commissions, and judicial fair hearings. Reviews medically appropriate clinical guidelines and other appropriate criteria with medical directors on denial decisions. Supplies criteria supporting all recommendations for denial or modification of payment decisions. Serves as a clinical resource for utilization management, CMOs, physicians and member/provider inquiries/appeals. Provides training and support to clinical peers. Identifies and refers members with special needs to the appropriate Molina program per applicable policies/protocols. Job Qualifications REQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice. Experience demonstrating knowledge of ICD-10, Current Procedural Technology (CPT) coding and Healthcare Common Procedure Coding (HCPC). Experience working within applicable state, federal, and third-party regulations. Analytic, problem-solving, and decision-making skills. Organizational and time-management skills. Attention to detail. Critical-thinking and active listening skills. Common look proficiency. Effective verbal and written communication skills. Microsoft Office suite and applicable software program(s) proficiency. PREFERRED QUALIFICATIONS: Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care certifications. Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics. Billing and coding experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $29.05 - $67.97 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Caregiver Full-time
Epic Healthcare

Caregiver

apartment Epic Healthcare location_onTemple City, CA
Now Hiring: Caregiver Come Join the team everyone is talking about!!! #Caregiver If you are currently an employee, a $100 referral bonus for sharing your amazing work experience with your friend and getting them hired. Santa Anita Assisted Living is a pillar in assisted living in Temple City, CA. We approach every day with one goal: To improve the lives we touch through high-quality healthcare and extraordinary compassion. Santa Anita Assisted Living 5600 Gracewood Avenue Temple City, CA 91780 716.325.1056 Why work for us? Caring and compassionate environment Opportunity for growth, success and longevity Come join employees who have become family! Supportive Management team Benefits: Beautiful work environment Competitive Wages and Benefit Package Flexible Schedule Paid Time Off Overtime Pay 401(k) Now Hiring: Caregiver Responsibilities Caregiver : The caregiver is responsible for providing exceptional ADL services to a group of residents in an assisted living setting. Personal services could include toileting, diaper changing, bathing, feeding and grooming. The caregiver will also encourage socialization and participation in community activities. Qualifications of Caregiver : High school diploma preferred. Must be fully vaccinated for Covid-19 Caregiver experiene preferred Ability to lift up to 25 pounds at a time Ability to reach, bend, kneel and stand for (sometimes) a long period of time Serious Applicants Santa Anita Retirement Center is an equal opportunity employer and makes employment decisions on the basis of merit. Qualified applicants are considered for employment without regard to race, religion, sex or gender, sexual orientation, gender identity or expression, pregnancy, marital status, national origin, citizenship, veteran status, ancestry, age, physical or mental disability, genetic information, or any other consideration made unlawful by applicable laws . Santa Anita Retirement Center will consider qualified applicants with criminal histories in a manner consistent with state, federal, or local law.