Top 191 rn clinical quality Jobs in madera ca

UM Coordinator
River Vista Behavioral Health —Madera, CA
- $50 - $55 an hour
- Full-time
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
RN Wound Treatment Nurse
Madera Care Center —Madera, CA
- $42 - $45 an hour
- Full-time
- Background check
- Skilled nursing facility
- RN License
- Disability insurance
- Health insurance
Quick Apply
RN, L&D PRN
Community Health System —Fresno, CA
- $55.85 - $72.61 an hour
- PRN
- Float pool
- RN License
- Hospital
- Free parking
RN, Oncology PRN
Community Health System —Fresno, CA
- $55.85 - $72.61 an hour
- PRN
- Float pool
- RN License
- BLS Certification
- Free parking
Sub Acute RN Infection Prevention Practitioner
Clinical Management Consultants —Madera, CA
- $108,140 - $141,600 a year
- Full-time
- Nursing
- Hospital
- Mid-level
- Health insurance
- Retirement plan
HIM Data Specialist - Clinical Documentation/Coding
Valley Children's Healthcare —Madera, CA
- $26.65 - $37.90 an hour
- Email
- RN License
- High school diploma or GED
- Critical & Intensive Care
RN, Cardiovascular ICU
Community Health System —Fresno, CA
- $45.29 - $64.30 an hour
- RN License
- BLS Certification
- Mid-level
- Free parking
- 403(b) matching
Director of Patient Care Services (RN)- Hospice
VITAS Healthcare —Fresno, CA
- $112,000 - $150,000 a year
- Full-time
- Nursing
- Surgery
- RN License
- Disability insurance
- Health insurance
Quick Apply
OR Circulating RN – Travel / Short-Term Contracts
Recruitment Alley LLC —Fresno, CA
- $60 - $70 an hour
- Temporary
- Background check
- Surgery
- Current TB test
- Flexible schedule
Quick Apply
5d
Nurse Practitioner/Physician Assistant
Monogram Health Professional Services —Fresno, CA
- $155,000 a year
- Weekends as needed
- Hybrid work
- Skilled nursing facility
- RN License
- BLS Certification
- Continuing education credits
- Mileage reimbursement
Quick Apply
Charge Nurse, Burn
Community Health System —Fresno, CA
- $56.18 - $73.04 an hour
- Part-time
- RN License
- BLS Certification
- Mid-level
- Free parking
- 403(b) matching
Charge Nurse, Burn
Community Health System —Fresno, CA
- $56.18 - $73.04 an hour
- Full-time
- RN License
- BLS Certification
- Mid-level
- Free parking
- 403(b) matching
RN Clinical Quality Coordinator
Community Health System —Clovis, CA
- $49.46 - $64.30 an hour
- 8 hour shift
- Nursing
- RN License
- 5 years
- Free parking
- 403(b) matching
Licensed Infection Preventionist, Post-Acute Services
Community Health System —Fresno, CA
- $52.15 - $67.80 an hour
- 8 hour shift
- Nursing
- RN License
- Inpatient
- Free parking
- 403(b) matching
RN Educator, Perioperative Services
Community Health System —Fresno, CA
- $53.76 - $69.89 an hour
- Full-time
- Nursing
- RN License
- 5 years
- Free parking
- 403(b) matching
RN, ICU
Community Health System —Fresno, CA
- $45.29 - $64.30 an hour
- Full-time
- RN License
- 5 years
- BLS Certification
- Free parking
- 403(b) matching
RN, ICU
Community Health System —Fresno, CA
- $45.29 - $64.30 an hour
- Full-time
- RN License
- 5 years
- BLS Certification
- Free parking
- 403(b) matching
Registered Nurse, Labor and Delivery
Community Health System —Fresno, CA
- $45.29 - $64.30 an hour
- Full-time
- RN License
- Hospital
- BLS Certification
- Free parking
- 403(b) matching
9d
RN Staff Development DSD, Skilled Nursing
Community Health System —Fresno, CA
- $52.15 - $67.80 an hour
- 8 hour shift
- Nursing
- RN License
- BLS Certification
- Free parking
- 403(b) matching
Registered Nurse (RN), Labor and Delivery
Community Health System —Fresno, CA
- $45.29 - $64.30 an hour
- Full-time
- RN License
- Hospital
- BLS Certification
- Free parking
- 403(b) matching
9d

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rn clinical quality jobs near madera ca

UM Coordinator

River Vista Behavioral Health
Madera, CA

Quick Apply

Job Details

Full-time
$50 - $55 an hour

Benefits

Health insurance
Dental insurance
401(k)
Paid time off

Qualifications

Teamwork
Inpatient
RN License
DSM-5
Patient assessment
Master's degree
Bachelor's degree
Negotiation

Full Job Description

Position Summary:

Facilitates a continuum of service while promoting positive outcomes and optimal reimbursement through coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting.

QUALIFICATIONS

Education: Bachelor’s Degree in Nursing, Psychology, or Social Work. Master's preferred.

Licensure: CA RN license required. License in Social Work, AMFT, Mental Health Counseling preferred

Experience:  A minimum of 3-5 years of experience working in an acute inpatient psychiatric setting as a treatment team member and/or utilization management, or years utilization management experience.

Shift time: Monday- Friday 8:00 am-4:30 pm

RN pay ranges- $50-$55

SW pay ranges- $37-$42

Knowledgeable in behavioral health managed care and clinical assessment skills to align patient acuity with level of care practice guidelines - Diagnostic and Statistical Manual of Mental Disorders (DSM-V).
Effective oral and written communication skills to support patient advocacy/negotiating skills to ensure quality reviews with payers
Solid understanding of acute inpatient psychiatric hospital operations, including both mental health and substance abuse treatment.

Essential Job Duties/Responsibilities

Performs timely, daily clinical reviews with all payer types (Managed Medicare, Managed Medicaid and commercial) to secure authorization for continued treatment (i.e. by fax, telephone or on-line) based on the payer’s criteria.
Functions as a key member of the multidisciplinary treatment team to educate and guide on level of care requirements and payer expectations for patient acuity and appropriate utilization.
Completes quality and timely appeal/denial letters. Participates in post claim recovery review and ongoing audit activity, supporting compliance with CMS and other regulators
Works collectively with hospital operations (social services, business office, Intake, Nursing) to ensure timely documentation is aligned with patient conditions.
Contributes to monthly utilization data trends using hospital data tools to report for the overall operation
Facilitates physician reviews with payers as required
Performs other duties as assigned/required by this position

Equal Employment Opportunity

It is the policy of the facility to provide equal opportunity in employment to all employees and applicants for employment. No person will be discriminated against in employment based on race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state, or local laws.

Americans with Disabilities Act

Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.

Service Excellence.

Service excellence is a part of all we do. Our standards include:

Treat everyone as a guest by making a good first impression, anticipating needs and displaying service recovery skills.
Demonstrate professionalism and excellence by looking professional, being accountable for actions and delivering excellence in our everyday work.
Practice teamwork by participating in decision making and process improvement, communicating effectively and focusing on the problem/issue, not the person.

Pay: $50.00 - $55.00 per hour

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off

Work Location: In person

Quick Apply

Refine Your Search

rn clinical quality jobs in madera ca

UM Coordinator

RN Wound Treatment Nurse

RN, L&D PRN

RN, Oncology PRN

Sub Acute RN Infection Prevention Practitioner

HIM Data Specialist - Clinical Documentation/Coding

RN, Cardiovascular ICU

Director of Patient Care Services (RN)- Hospice

OR Circulating RN – Travel / Short-Term Contracts

Nurse Practitioner/Physician Assistant

Charge Nurse, Burn

Charge Nurse, Burn

RN Clinical Quality Coordinator

Licensed Infection Preventionist, Post-Acute Services

RN Educator, Perioperative Services

RN, ICU

RN, ICU

Registered Nurse, Labor and Delivery

RN Staff Development DSD, Skilled Nursing

Registered Nurse (RN), Labor and Delivery

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