Top 80 Utilization review Jobs in Folsom Ca

MDS Coordinator
Anonymous —Placerville, CA
- From $40 an hour
- Full-time
- Anatomy knowledge
- HIPAA
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
3d
Utilization Review Case Management Supervisor
CorVel Corporation —Folsom, CA
- $77,960 - $120,368 a year
- Full-time
- Nursing
- RN License
- Sales
- Health savings account
- Disability insurance
Quick Apply
RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)
Molina Healthcare —Sacramento, CA
- $30.37 - $59.21 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Discharge planning
- Health insurance
RN, Care Manager, Utilization Management (Part-time, Every weekend - Remote)
Adventist Health —Roseville, CA
- $59.23 - $81.24 an hour
- Part-time
- Remote
- Nursing
- RN License
- Mid-level
11d
Professional Review Nurse
CorVel Corporation —Folsom, CA
- $70,304 - $85,473 a year
- Full-time
- Remote
- Nursing
- RN License
- Data analysis skills
- Health savings account
- Disability insurance
Quick Apply
RN, Care Manager, Utilization Management
Adventist Health —Roseville, CA
- $59.23 - $81.24 an hour
- Nursing
- RN License
- Mid-level
1d
Care Review Clinician, RN/LPN
Molina Healthcare —Sacramento, CA
- $27.61 - $53.83 an hour
- Full-time
- Mid-level
- LPN
- Acute care experience
- Health insurance
CA Telephonic Case Manager I
CorVel Corporation —Folsom, CA
- $30.64 - $45.80 an hour
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
9d
Speech Language Pathologist
Roseville Point Health & Wellness Center —Roseville, CA
- $58 - $62 an hour
- Part-time
- CPR Certification
- Management
- Writing skills
- Health insurance
Quick Apply
Physical Therapist
Roseville Point Health and Wellness Center —Roseville, CA
- $58 - $62 an hour
- Full-time
- Background check
- CPR Certification
- Management
- Health insurance
Quick Apply
MD or DO for Skilled Nursing
Community Health Centers of America —Sacramento, CA
- $240,000 - $350,000 a year
- Part-time
- Medicine
- Skilled nursing facility
- BC/BE
- Paid holidays
- Health insurance
Quick Apply
10d
RN Case Manager
AMN Healthcare —Sacramento, CA
- $1,800 - $2,700 a week
- 8 hour shift
- RN License
- Hospital
- BLS Certification
- Paid jury duty
- Paid holidays
9d
RN Case Manager
AMN Healthcare —Carmichael, CA
- $1,800 - $2,700 a week
- 8 hour shift
- Nursing
- RN License
- Hospital
- Paid jury duty
- Paid holidays
RN Case Manager
AMN Healthcare —Sacramento, CA
- $1,800 - $2,700 a week
- 8 hour shift
- RN License
- Hospital
- BLS Certification
- Paid jury duty
- Paid holidays
9d
Psychiatrist
Beloved Ones —California
- $200,000 - $250,000 a year
- Weekends as needed
- Remote
- Background check
- Medicine
- Doctoral degree
- Flexible schedule
Quick Apply
Senior Director Clinical Quality and Policy
Delta Dental —Rancho Cordova, CA
- $190,254 - $439,724 a year
- Full-time
- Hybrid work
- Background check
- Analysis skills
- Bachelor's degree
- Paid holidays
- Health insurance
CA Telephonic Case Manager II
CorVel Corporation —Folsom, CA
- $31.46 - $47.59 an hour
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
CA Medical Case Manager I
CorVel Corporation —Folsom, CA
- $30.64 - $45.80 an hour
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
Travel RN - Case Management/Utilization Review - Case Management
American Traveler —Carmichael, CA
- $3,246 a week
- 8 hour shift
- Acute care
- Nursing
- RN License
Quick Apply
CA Medical Case Manager II
CorVel Corporation —Folsom, CA
- $31.46 - $47.59 an hour
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply

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utilization review jobs near folsom ca

MDS Coordinator

Anonymous -
Placerville, CA

Quick Apply

Job Details

Full-time
From $40 an hour
3 days ago

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Hospice experience
HIPAA
EMR/EHR
Health information management
Medical terminology

Full Job Description

Job Overview
We are seeking a dedicated and detail-oriented MDS Coordinator to join our healthcare team. In this vital role, you will oversee the comprehensive assessment process for long-term and short-term care residents, ensuring accurate and timely completion of the Minimum Data Set (MDS) assessments. Your expertise will support quality patient care, compliance with federal and state regulations, and reimbursement accuracy. You will collaborate closely with interdisciplinary teams, including nursing, therapy, social services, and medical staff, to facilitate effective discharge planning and clinical documentation improvement. This position offers an exciting opportunity to make a meaningful impact on patient outcomes while advancing your career in healthcare management.

Responsibilities

Coordinate and complete comprehensive MDS assessments in accordance with CMS (Centers for Medicare and Medicaid Services) guidelines and deadlines
Review medical records, clinical documentation, and care plans to ensure accuracy and completeness of data
Collaborate with interdisciplinary teams to gather necessary information for accurate coding and documentation review
Ensure compliance with all federal, state, and local healthcare regulations including HIPAA, long-term care regulations, and hospital standards
Utilize EMR (Electronic Medical Records) systems such as Epic, Cerner, Athenahealth, eClinicalWorks, or similar platforms to document assessments and update patient records
Conduct utilization review and management activities to optimize patient care plans and reimbursement processes
Stay current on changes in ICD-10/ICD coding, CPT coding, DRG assignments, and health regulation policies to maintain compliance and accuracy in documentation
Support discharge planning efforts by providing detailed clinical data for effective patient transition across care settings
Participate in clinical documentation improvement initiatives to enhance coding accuracy and reimbursement integrity
Maintain detailed records of assessments, coding activities, and compliance audits to support quality assurance processes

Experience

Proven experience with MDS coordination within long-term care facilities or hospitals with inpatient or ICU experience preferred
Strong knowledge of ICD-10/ICD coding, CPT coding, DRG classification, and Medicare regulations
Experience working with EMR/EHR systems such as Epic, Cerner, Athenahealth or eClinicalWorks is highly desirable
Background in managed care environments or utilization review is a plus
Critical care or acute care experience including ICU or Level I/II trauma center exposure enhances candidacy
Familiarity with health information management standards aligned with CMS (Centers for Medicare & Medicaid Services) guidelines
Knowledge of HIPAA regulations along with state healthcare policies governing medical documentation standards
Prior experience in nursing home settings or hospice care is advantageous
Strong understanding of anatomy, physiology, medical terminology, and clinical documentation standards to accurately interpret medical records
Excellent case management skills coupled with a proactive approach to discharge planning and patient care coordination

Join us in this dynamic role where your expertise directly influences patient outcomes while supporting regulatory compliance. We are committed to fostering an environment that values professional growth through ongoing education and collaboration. If you thrive in a fast-paced healthcare setting that emphasizes precision and teamwork, we want to hear from you!

Pay: From $40.00 per hour

Benefits:

Dental insurance
Health insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

utilization review jobs in folsom ca

MDS Coordinator

Utilization Review Case Management Supervisor

RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)

RN, Care Manager, Utilization Management (Part-time, Every weekend - Remote)

Professional Review Nurse

RN, Care Manager, Utilization Management

Care Review Clinician, RN/LPN

CA Telephonic Case Manager I

Speech Language Pathologist

Physical Therapist

MD or DO for Skilled Nursing

RN Case Manager

RN Case Manager

RN Case Manager

Psychiatrist

Senior Director Clinical Quality and Policy

CA Telephonic Case Manager II

CA Medical Case Manager I

Travel RN - Case Management/Utilization Review - Case Management

CA Medical Case Manager II

I want to receive the latest job alert for utilization review in folsom ca

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