jobs in Clovis, CA

Nursing Jobs in Clovis, CA

Utilization Management Registered Nurse

$60.15 - $85.81 / hour

Job Summary: The Utilization Management Nurse supports the case management department by providing a variety of utilization management functions including but not limited to daily screening of patient admission relative to specified criteria, active involvement in denial management, acting as a resource to staff regarding clinical criteria, communication with payors to address concerns and other duties as assigned. The Utilization Management Nurse will work collaboratively with the Utilization Nurse Program Coordinator to ensure compliance with regulatory, organizational and department requirements. The Utilization Review Nurse will receive direction from the Utilization Review Program Coordinator for daily and long term tasks and projects. Qualifications: Schedule Full-time 9 shifts per two-week pay period Shift: 11:00 a.m. – 7:30 p.m. with rotating weekend coverage Hybrid Position – Primarily remote/work-from-home, with an expectation to be on-site at least once per month, or more frequently as business needs or projects require. Candidates must reside locally and be able to commute to the worksite as needed. Education Associates Degree Nursing (required) Bachelors Degree Nursing or related field (preferred) Licenses and Certifications RN - Registered Nurse License - CA-BRN - California Board of Registered Nursing (required) Work Experience Minimum three (3) years Full time equivalent RN experience in an acute care hospital. (required) Pediatric experience and experience in Case Management and/or Utilization Review. (preferred) Skills and Abilities Knowledge of UM regulations. Knowledge of private and public payer reimbursement practices and procedures. Excellent organizational and communication skills and ability to work with a variety of health care professionals. Ability to work independently. Computer Skills Proficiency with word processing, spreadsheets and database software. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Compensation Range: $60.15 - $85.81 Workshift: Day (United States of America) Position Exempt: No FTE %: 90 Scheduled Weekly Hours: 36 Daily Hours: 8 Have Questions? Call Recruitment Services at 559-353-7071 or email us at recruiting@valleychildrens.org Disclaimer: Final compensation will be dependent upon skills and experience.

Per Diem

1 week ago

Registered Nurse 8PM to 4:30AM

Vineyards at Fowler Fowler, CA

$40 - $50 / hour

Responsibilities of the Registered Nurse include but are not limited to: Ensures proper resident care is maintained in a clean and safe environment. Develop and ensure the nursing care plan and collaborate with physicians, therapists, and nursing assistants Makes nursing diagnoses, which serve as the basis for the strategy of care Collaborates with the resident, members of the healthcare team Records the administration of medication Monitor assigned staff to ensure established safety regulations are followed and that all tasks are performed following all state and government regulations and safety procedures as outlined by the facility Follows procedures related to the use of nursing equipment and supplies Performs other duties as directed Qualifications of the Registered Nurse include: An active RN license Prior experience as an RN in a nursing community The desire to care for residents and act with integrity The ability to work flexible hours

MDS

Full-time

1 week ago

MDS Coordinator (RN)

Skilled Nursing of California Fowler, CA

$52 - $54 / hour

POSITION DESCRIPTION Responsible for timely and accurate completion of both the RAI process and care management process from admission to discharge in accordance with company policy and procedures, and Federal, State and Certification guidelines, and all other entities as appropriate- Minimum Data Set, discharge and admission tracking, etc. With direction from the Director of Nursing and VP of Clinical Reimbursement, may coordinate information systems operations and education for the clinical department. QUALIFICATIONS • Graduate of an approved RN program and licensed in the state of practice, required. • Minimum of 2 years of nursing experience in a Skilled Nursing Facility preferred. • Excellent knowledge of Case-Mix, the Federal Medicare PPS process, and Medicaid reimbursement, as required. • Thorough understanding of the Quality Indicator process. Knowledge of the OBRA regulations and Minimum Data Set. • Knowledge of the care planning process. • Experience with MDS 3.0, preferred.. • Maintains current MDS status of assigned residents according to state and federal guidelines. • Maintains the frequent and accurate data entry of resident information into appropriate computerized MDS programs. • Completes accurate coding of the MDS with information obtained via medical record review as well as observation and interview with facility staff, resident and family members. • Other duties, responsibilities and activities may change or assigned at any time with or without notice RESPONSIBILITIES • Works in collaboration with the Interdisciplinary Team to assess the needs of the resident; Provides interdisciplinary schedule for MDS assessments and care plan reviews as required by governing agencies. • Ensures that the Interdisciplinary team makes decisions for either completing or not completing additional MDS, assessments based on clinical criteria as identified in the most recent version of the RAI User’s Manual. • Assist with coordination and management of the daily stand up meeting, to include review of resident care and the setting of the assessment reference date(s). • Complies with federal and state regulations regarding completion and coordination of the RAI process. • Monitors MDS and care plan documentation for all residents; ensures documentation is present in the medical record to support MDS coding. • Maintains current MDS status of assigned residents according to state and federal guidelines. • Maintains the frequent and accurate data entry of resident information into appropriate computerized MDS programs. • Completes accurate coding of the MDS with information obtained via medical record review as well as observation and interview with facility staff, resident and family members. • Other duties, responsibilities and activities may change or assigned at any time with or without notice.