Fountain Valley Regional Hospital is proud of the full range of quality services we provide. Since 1971, we have dedicated our efforts to meet and serve the medical needs of our growing community. We were the first hospital in Orange County to offer residents an accredited Chest Pain Center and a Thrombectomy Receiving Center certified by The Joint Commission. We are one of only two certified Pediatric ICUs in Orange County and the only hospital in Fountain Valley and Huntington Beach with a Level III Neonatal ICU. Weâ��re proud of the efforts of our physicians, nurses and staff who strive to provide you with the best care possible.
We offer competitive salaries and benefits including a matching 401(k), several health & dental plans to choose from, generous tuition assistance plans, and relocation assistance for select positions.
The individual in this position works under direction of the Director of Case Management and coordinates utilization reviews of managed care contracts using established guidelines and processes. Ensures all clinical operations comply with Medicare and Medicaid guidelines and other managed care policies.
â�¢High School diploma or equivalent.
â�¢Must learn and be proficient in InterQual criteria and clinical reviews within 6 months.
â�¢Demonstrated knowledge of medical terminology.
â�¢Skills required include: excellent organizational skills, excellent verbal and written communication skills, demonstrated problem solving skills, and proficient in Microsoft Office including Word and Excel spreadsheets.
â�¢LVN or comparable clinical knowledge
â�¢Acute hospital experience preferred
â�¢Data Analytic skills preferred
â�¢Knowledge of utilization management practices
â�¢Understanding of capitated plans, cost occurrences, management of resources consumption preferred.
Primary Location: Fountain Valley, California
Facility: Fountain Valley Regional Hospital and Medical Center
Job Type: PT2Y
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1905016062
About Fountain Valley Regional Hospital and Medical Center