Current Job Openings | Lakeside Community Healthcare

Administrative Assistant

Location: Agoura Hills, CA

Job Duties:

• Will provide primary administrative support to the Claims Director and Claims Department
• Will screen telephone calls from providers and claimants and triage appropriately
• Will perform special projects having to do with claims information
• Organizes and maintains files in the office
• Prepares correspondence as requested
• Maintains confidentiality of all member and medical/clinical information
• Performs other duties as directed by management.

Requirements:

• 2-3 years of recent administrative assistant exp in a business environment
• Demonstrated ability to effectively handle difficult callers.
• High level of skill and exp working with Word and Excel required. Must have exp in creating and managing spreadsheets
• Ability to work in a multi-tasking environment.

Apply Online Now! or fax your resume to 818.707.1197.

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Care Management In-Patient Coordinator

Location: Glendale

Multi-specialty medical group located in the Glendale currently has outstanding an excellent opportunity for a dedicated Care Management Coordinator in our busy corporate office. The qualified individual will support the hospital based Care Mgmt. Nurse by performing all necessary clerical functions for the effective and timely flow of critical information from the time of patient admission through discharge of the inpatient stay and required follow-up care.

• Must be able to handle confidential and sensitive information with discretion
• Must be detail-oriented with strong communication and organization skills
• Must have strong data entry skills

Flexibility and openness to changing priorities

Familiarity with medical industry is required.

Must have at least one year experience.

Apply Online Now! or fax your resume to 818.707.1197.

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Claims Examiners 

Location:Agoura Hills, CA

Job duties:

• Investigates and researches specialized claims to determine members’ eligibility, benefit coverage, and authorization
• Returns incomplete claims back to providers with specific request in order to process that claim
• Denies unauthorized and ineligible claims
• Batches and balances processed claims on a daily basis
• Analyzes and processes each specialized claim for appropriate procedure/diagnosis codes prior to adjudication
• Reviews the claims entry for appropriate adjudication in compliance with benefit coverage, vendor contract, and appropriate disposition code
• Handles incoming phone calls from providers/members regarding claims inquiries

Requirements:

• 2-3 years of recent medical claims processing exp for professional and/or institutional claims.
• Must possess EZ-Cap exp.
• Knowledge of claims processing policies, procedures and concepts relating to claims processing and reports.
• Strong communication and telephone skills, overall office skills, including typing, filing and photocopying.

Apply Online Now! or fax your resume to 818.707.1197.

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LVN Quality Clinical Reviewer

Location: Glendale

Job duties:

• Will conduct audits at provider offices in the greater San Fernando Valley, where EMR access is not available.
• Audits entail the review of medical records, HEDIS and CPGs info and the compilation of the results in report formats.
• Other responsibilities include implementation of a Disease Management program.

Requirements

• Strong analytical and computer skills required with specific work exp in quality audits.
• Must possess valid CA LVN license

Apply Online Now! or fax your resume to 818.707.1197.

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Medical Assistant

Location: Various

Job duties:

• Assist patients to exam rooms and obtain complete and accurate vital signs.
• Obtain and document all pertinent information in patient’s charts.
• Anticipate, assist and perform procedures ordered by the phone.
• Maintain timely patient flow and room availability.
• Maintain patient safety and confidentiality.
• Reinforce patient education and participate in patient teaching.
• Stock and maintain exam rooms, nursing stations, and individual workstations.
• Participate in back office duties such as cleaning and sterilizing instruments and ordering supplies.
• Maintain a current accurate surgical log, procedure log, lab log, and patient tickler files, as appropriate.
• Maintain and monitor all equipment used for patient care and testing, Report any discrepancy to supervisor.
• Assist with training and orientation of new personnel.
• Actively participate in nursing QI by identifying problems, providing solutions and evaluating outcomes.
• Ensure appropriate handling and accurate documentation of all medications ordered by the provider.
• Knowledgeable with referral system and ensures accurate and timely follow through with all referrals generated.
• Obtains medication and/or procedure prior authorizations for patients as required by their health plan.
• May schedule follow up appointments and/or provide front desk coverage as needed.
• Follow up on patient messages per physician/provider’s orders.
• Universal precautions utilized in all patient care.
• Front/Back office duties are interchangeable per medical office and required as needed.
• Other duties as assigned.

Requirements:

• Graduate from an accredited Medical Assistant Program
• Current CPR Certification maintained.
• One-year experience in a physician office or clinic.
• Annual TB skin test or X-Ray required.

Apply Online Now! or fax your resume to 818.707.1197.

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Medical Phone Receptionist

Location: Various

Ideal candidate will be an exceptional communicator and team player, be well organized, detail oriented, and possess excellent telephone and customer service skills. Requires medical terminology and at least one year medical front office experience working in a doctor's office or healthcare setting.

Apply Online Now! or fax your resume to 818.707.1197.

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P4P Specialist

Location: Glendale

Job duties

• Will perform the functions of collection and documenting medical screening and service data for all eligible members, interfacing with physicians, vendors, members and internal depts to collect required data. 
• Will audit, report and monitor all internal and external performance and analytics measurement data.

Requirements

2 yrs min exp in performing P4P and HEDIS functions, data abstraction and compilation of reports. Must possess advanced computer skills including Excel, Access. Must have full understanding of State and Federal compliance regulations for P4P and HEDIS.

Apply Online Now! or fax your resume to 818.707.1197.

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Urgent Care RN/LVN

Location: Burbank

Will assist providers with patient care and documentation.
 
Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Triage patient calls for medical care.
• Assist with patient follow up calls.
• Assist with processing, documenting, and communicating prescription refills (per approved written guidelines), and test results.
• Assist with medication administration.
• Performs allergy testing upon the order of the health care provider.
• Assist with patient examinations (as instructed by provider)
• Assist with the development of clinical protocols.
• Obtain and document all pertinent information in patient’s charts.
• Maintain patient safety and confidentiality.
• Answer and address patient inquiries, questions and concerns.
• Reinforce patient education and participate in patient teaching.
• Stock nursing stations.
• Primary responsibility for initiating and maintaining peripheral lines, administering medications, maintaining and ordering of medications and supplies for infusion services.
• Assist with surgeries.
• Actively participate in nursing QI by identifying problems, providing solutions and evaluating outcome.
• Participate in the planning and development of programs for infusion, wound care, education, etc.
• Ensure appropriate handling and accurate documentation of all medications ordered by the provider.
• Utilize universal precautions in all patient care.
• Maintain patient flow and availability and in the case of patient overflow, assists medical assistants in preparation of examination rooms, preparation of patients for exam, and taking of vital signs of patients. 
• Anticipate, assist and perform procedures ordered by phone.
• Maintain confidentiality and follow HIPAA Policies.
• Train medical assistants to be more efficient. Assist with training and orientation of new back office personnel.
• Provide oversight with the Back Office Supervisor and Office Manager of the Medical Office Staff and regulatory compliance.
• Assists in training the staff in relation to safety, blood borne pathogens, and current health issues.
• Participates in meetings as directed by the administration.
• Participates in educational/informational meetings and seminars.

Certificates, Licenses, Registrations, and Experience
Current active RN Registered License from the State of California or LVN License and CPR certification. Must maintain CEUs. Two years experience required.

Apply Online Now! or fax your resume to 818.707.1197.

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Utilization Management Review Nurse

Location: Glendale

Lakeside Community Healthcare is seeking Utilization Management Review Nurses who are familiar with utilization review processes and InterQual Outpatient Criteria. The preferred candidate will be an RN, although LVNs with appropriate experience will be considered.

The Utilization Review Nurse will review provider requests for services against established health plan benefits, standard review criteria, and referring cases not meeting criteria to the appropriate medical director for review. The Utilization Review Nurse will evaluate the options and services required to meet the members’ health and psycho-social services needs, in support and collaboration with patients’ diagnosis (or diagnoses)

The goal of Utilization Review is to assist the provider in identifying appropriate options for the level of care that will assist the patient in achieving optimum stability of health status within their defined disease state and/or diagnosis. General responsibilities Include:

• Manage assigned workload within established performance standards.
• Support and lead the Prior Authorization Coordinators to manage prior authorizations in a most effective and efficient manner.
• Establish and maintain positive relationships with providers, patients and caregivers through telephonic and / or onsite visits.
• Establish positive relationships with treating physicians and other health care providers through collaborative problem solving.
• Perform Utilization Review - pre-authorization, review as needed for outpatient services and/or predetermination reviews for services or levels of care requiring authorization according to health plan, state, and federal regulations.
• Maintain open communication flow with Vital Care Team (complex cases) or Social Services staff to facilitate smooth transition and follow-ups care as needed.
• Maintain all required documentation in the information data systems in a timely manner.
• Participate in case conferences, clinical in-services and other educational opportunities.
• Serve as a resource for recognized areas of expertise.
• Perform other tasks as assigned by supervisor/manager/Director.

Qualifications:

• Requires a current California RN or LVN license.
• Must have at least two years of prior Utilization Management experience.

Apply Online Now! or fax your resume to 818.707.1197.

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