Qureos Mentor

Loma Linda University Health

Loma Linda University Health is a faith-based academic medical center located in Southern California's Inland Empire. Established in 1905, it provides comprehensive clinical care, education, and research through its six hospitals and numerous healthcare programs. With a commitment to physical, mental, and spiritual healing, the organization employs over 18,000 healthcare professionals and serves more than a million outpatients annually. Loma Linda University Health is recognized for its excellence in patient care and nursing, and it aims to bring hope to patients and families during their most vulnerable moments.

Job Summary: The Patient Navigator&ndash;Cancer coordinates and supports patients&rsquo; access to oncology services from diagnosis or referral through all phases of care. This role serves as a central liaison between patients, families, providers, and support services by ensuring timely, accurate, and compassionate communication. Responsibilities include coordinating appointments, treatments, procedures, and surgeries; securing authorizations and financial clearance; and collecting and managing required medical documentation. They are responsible for processing incoming referrals, ensuring completeness of referral documentation, and facilitating timely scheduling and care coordination. This includes actively managing and prioritizing work queues and utilizing reporting tools to monitor referral status, identify delays, and improve patient throughput. The role requires consistent follow-up on pending items, resolving work queue tasks, and collaborating with clinical and administrative teams to ensure patients move efficiently through the continuum of care. They ensure a smooth patient flow by directing patients to appropriate services, facilitating orders, and supporting care delivery under the supervision of licensed clinical staff. In addition, the role contributes to a safe, welcoming, and efficient care environment by monitoring clinic areas, addressing patient needs, maintaining confidentiality, and responding appropriately to sensitive or high-risk situations. Delivers high-quality customer service, provides emotional support to patients and families, collaborates with a diverse care team, and demonstrates flexibility to float to various areas as needed. Performs other duties as assigned.
 
 
Education and Experience: High School Diploma or GED required; Associate degree preferred. Minimum of one year of experience in a medical office or customer service setting required.
 
 
Knowledge and Skills: Knowledge of medical terminology, insurance processes, and ICD/CPT coding for authorizations and billing required; familiarity with inpatient and outpatient settings preferred. Proficient in Microsoft Office, electronic medical records, and office equipment, with strong data entry and typing skills. Demonstrates ability to interpret clinical information, apply critical thinking, and manage multiple tasks with strong organization, accuracy, and attention to detail. Communicates effectively in English (Spanish preferred), including professional telephone etiquette, while maintaining confidentiality, empathy, and cultural sensitivity. Able to work independently and collaboratively, adapt to changing priorities, and perform under pressure with sound judgment and professionalism. Understands unlicensed assistive personnel scope, patient care fundamentals, and safety practices, including proper escalation of concerns. Capable of operating basic office equipment, completing accurate documentation, and performing essential physical functions required for a clinical environment. 
 
Licensures and Certifications: None.

Patient Navigator-Cancer

<div>Department: UHC: FPBO - Administration

Job Summary: The Trainer-Quality Assurance Team Lead are responsible for training new and retraining existing staff on revenue cycle department processes. These processes can include registration and payer plan training, scanning, charge entry, Epic work queues, payment posting, refunds, AR follow-up and other revenue cycle functions within the various departments of the FPBO. Assist Directors in establishing and maintaining a training document of reference material used by each department. Works in collaboration with the FPBO Managers, Supervisors and Client Service Representatives to provide Quality Assurance audits for the purpose of analyzing billing procedures &amp; developing training solutions that facilitate resolution of billing issues. Must understand payer issues that affect the billing and collection of all payer types. Demonstrates ability to communicate, both verbally and in writing, key information regarding best practices of each respective unit within the FPBO. Performs other duties as needed.
 
 
Education and Experience: High School diploma or GED required; Associates Degree preferred. Minimum two years of ambulatory health care, billing, or training experience required. Minimum two years' experience in Commercial Contract or Managed Medi-cal billing, auditing, and collecting required.
 
 
Knowledge and Skills: Knowledge of adult learning theory and practice, LLUHC business operations, and current software applications. Must possess above average computer skills. Excellent writing and presentation skills required. Maintains a good working knowledge of all aspects of the revenue cycle. Essential Interpersonal Skills: Ability to work well with and motivate others. Possess excellent listening, communication and teaching skills; approachable. Essential Mental Abilities: Requires analysis of data; patience; thoroughness; ability to multi-task; good organizational skills. Bilingual (English/Spanish) skills preferred. Essential Sensory Abilities: Requires adequate visual, hearing and tactile acuity to proficiently perform essential duties. 
 
Licensures and Certifications: None.</div>

Trainer-QA Team Lead

<div>Department: UHC: Peds - RICA

Job Summary: The MA/PSR-Grant performs patient oriented procedures with the ability to work with and evaluate specific age groups and tasks within the scope of their education and training, under the supervision of a physician or licensed staff person. The MA/PSR monitors &amp; controls patient flow for check-in, check-out, and appointment procedures. Performs other duties as needed.
 
 
Education and Experience: High school diploma or GED required. Graduate of a Medical Assistant (MA) program required. Minimum one year Medical Assistant experience required, preferably in an ambulatory setting.
 
 
Knowledge and Skills: Medical Assistant principles and practices in an ambulatory setting. Able to: read; write legibly; speak in English (and Spanish preferred) with professional quality; use computer and software programs necessary to the position; troubleshoot and calibrate patient care equipment. Relate and communicate positively, effectively, and professionally with others; be assertive and consistent in following and/or enforcing policies; work calmly and respond courteously when under pressure; lead, supervise, teach, and collaborate; accept direction. Communicate effectively in English in person, in writing, and on the telephone; think critically; work independently with minimal supervision; perform basic math functions; manage multiple assignments effectively; work well under pressure; problem solve; organize and prioritize workload; recall information with accuracy; pay close attention to detail. Distinguish colors and smells as necessary for patient care; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the work place/patient care; see adequately to read computer screens, medical records, and written documents necessary to position; discern temperature variances through touch. 
 
Licensures and Certifications: Medical Assistant (MA) certification required. Basic Life Support (BLS) certification from the American Heart Association</div>

MA/PSR-Grant

<div>Department: UHC: Managed Care

Job Summary: This Claims Examiner 2-Mgd Care will process professional and hospital HMO Risk claims in accordance with the individual provider contracts in an accurate and timely manner, verify system assigned risk pool determination in accordance with HMO Division of Financial Responsibility matrix, initiate check run, perform standard reporting, ensure audit readiness, and process third party claims. Performs other duties as needed.
 
 
Education and Experience: High School Diploma or GED required. Bachelor's Degree in Computer Science, Business, or similar degree preferred. Minimum five years managed care claims processing experience with professional claims and institutional claims.
 
 
Knowledge and Skills: Knowledge of Microsoft Office Suite. Must be well versed in medical terminology, CPT, and ICD9/10 coding guidelines. Comprehensive understanding of institutional inpatient and outpatient hospital claims processing, DRG's and all other institutional calculation standards. Comprehensive understanding of professional claims adjudication process. Understanding of the Managed Care health care delivery system. Able to use a computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/troubleshoot basic office equipment required for the position. Able to work calmly and respond courteously when under pressure; collaborate and accept direction. Able to think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position. 
 
Licensures and Certifications: Certified Professional Coder preferred. Valid Driver's License at time of hire.</div>

Claims Examiner 2-Managed Care

<div>Job Summary: The Clinical Admission Nurse-RN is an important part of the patient care delivery team and exhibits proficient decision-making skills. Utilizes discretion and independent judgment to prioritize, direct and control all patient admissions and transfers from multiple portals of entry into Loma Linda University Medical Center (LLUMC) and Loma Linda University Children's Hospital (LLUCH). Both hospitals, are large tertiary academic medical centers with level one trauma designation separately licensed under the umbrella of The Loma Linda University Health System (LLUHS). Maintains an organization-wide perspective and objectivity when prioritizing patient placement and bed utilization based on clinical assessment, age, diagnosis, level of care, isolation, and other pertinent factors. Follows the established Professional Practice Model (Duffy's Quality Caring Theory) to achieve appropriate level of care for the patient. Exhibits flexibility and advanced critical thinking skills in monitoring all portals of entries into LLUMC and LLUCH. This includes both urgent and same-day requests for patient beds, changes in patient status, add on surgeries, inter-facility bed requests, and reassigning patients prior to placement according to patient needs. Will need to monitor bed availability and communicate changes with involved departments. Connects and corresponds with all levels of staff and administration to ensure patient flow is consistent and uninterrupted. Performs clinical screening of inter-facility transfer requests, for medical necessity and need for higher level of care while following all state, federal, and internal policies and guidelines. Establishing pertinent, timely and effective communication with the appropriate healthcare providers and transfer staff. Coordinates the patient transfer process. Collaborates with department leadership in developing, revising and implementing departmental and organizational wide admission, discharge, transfer (ADT) process, patient placement/bed utilization policies and procedures. Identifies legal issues pertinent to the ADT process and ensures compliance with Emergency Medical Treatment and Active labor Act (EMTALA). Functions within the expectations of an accomplished professional nurse and meets nursing excellence standards to maintain Magnet Recognition as outlined by the American Nurses Credentialing Center. Represents nursing as an empowered profession and readily embraces new knowledge, innovations and improvements. Provides a positive influence to facilitate change and optimize patient satisfaction and outcomes. Utilizes exemplary interpersonal skills and cooperates harmoniously with others at all levels. Contributes to a work environment of caring and cooperation among a culturally diverse workforce and patient population. Performs other duties as needed.
Education and Experience: Bachelor's Degree in Nursing required for external hires. Exception(s) may be granted as follows: 1) if currently enrolled in a nursing bridge program (AS degree to DNP degree), proof of 25% program completion required. DNP degree to be completed two and a half years post hire date. Exception to completion date may be granted for extenuating circumstances; 2) if employed in a LLUH entity with an Associate or Diploma Degree at time of application, AS or Diploma degree is acceptable. Minimum of one year experience in nursing required. Minimum of one year experience demonstrating leadership ability required.
Knowledge and Skills: Strong critical thinking skills, able to work calmly in a stressful faced paced environment. Good clinical screening skills and understanding of a wide range of clinical diagnosis. Demonstrates strong communication skills in obtaining cooperation and support from a broad range of people and ability to work effectively with physician, nursing, administrative and ancillary staff. Substantial knowledge of state and federal healthcare regulations and EMTALA guidelines. Always exhibits a professional behavior and appearance. Able to speak, read and write legibly in English with professional quality; use computer, printer and software programs necessary to the position, e.g., Word, Excel, Outlook, PowerPoint, electronic medical record, electronic event reporting program; relate and communicate positively, effectively and professionally with others; able to inspire and motivate others; be assertive and consistent in following and enforcing policies; work calmly and respond courteously when under pressure; lead, supervise, teach and collaborate; accept direction; think critically; use sound judgment based on factual information and clinical knowledge; work independently with minimal supervision; meet deadlines; perform basic math and statistical functions; demonstrate expert time management and effectively manages and prioritizes fluctuating workload to meet position demands; recalls information with accuracy; pays close attention to detail; hears sufficiently for general conversation in person and on the telephone; identifies and distinguishes various sounds associated with the work place; sees adequately to read computer screens, medical records and written documents necessary to position; and displays personal qualities such as kindness, compassion, understanding, integrity, respect, discretion and confidentiality.

Licensures and Certifications: Active California Registered Nursing (RN) license required.</div>

Clinical Admission Nurse-RN NOC. Per diem.

Job Summary: The Pharmacy Technician-One (1) Outpatient is primary responsibilities include satisfying the needs of the patient with respect to prescription processing, refill authorization, insurance billing, filling of medications and operating the cash register. Expected to cover both drop-off and pick-up windows. If working in the mail order pharmacy, also filling and packaging mail orders. Demonstrates flexibility and ability to cover multiple pharmacy locations as needed. Performs other duties as needed.
 
 
Education and Experience: Completion of Pharmacy Technician program through an accredited institution. Minimum one year of community pharmacy experience preferred.
 
 
Knowledge and Skills: Has a working knowledge in the area of billing. Medical terminology, typewriting, math and computer skills. Able to: read; write legibly; speak in English (and Spanish preferred) with professional quality; use computer and software programs necessary to the position; troubleshoot and calibrate patient care equipment. Able to relate and communicate positively, effectively, and professionally with others; be assertive and consistent in following and/or enforcing policies; work calmly and respond courteously when under pressure; lead, supervise, teach, and collaborate; accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; work independently with minimal supervision; perform basic math functions; manage multiple assignments effectively; work well under pressure; problem solve; organize and prioritize workload; recall information with accuracy; pay close attention to detail. Able to distinguish colors and smells as necessary for patient care; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the work place/patient care; see adequately to read computer screens, medical records, and written documents necessary to position; discern temperature variances through touch.
 
 
Licensures and Certifications: California Pharmacy Technician license required.

Pharmacy Technician 1-Outpt

Job Summary: The Patient Care Assistant (PCA), works under the direct supervision of the Registered Nurse (RN) in a fast-paced inpatient department licensed under Loma Linda University Medical Center (LLUMC), a Magnet Recognized large tertiary academic medical center. Provides direct and indirect age-specific and developmentally appropriate patient care, seeks information and clarification of duties as needed. Functions within the scope of practice for unlicensed assistive personnel and in accordance with policies, procedures, techniques and guidelines in all aspects of job duties. Meets qualifications and competencies as identified in the department-specific Plan for Providing Care. Exhibits behaviors that contribute to a highly motivated and high-performance team and displays professionalism in behavior, dress and conversation. Demonstrates flexibility and accepts changing assignments and job duties throughout the shift as requested. Utilizes effective interpersonal skills to maximize excellence in customer service and follows service excellence best practices to improve and maintain high patient, family satisfaction scores. Contributes to a work environment of caring and cooperation among a culturally diverse workforce and patient population. Performs other duties as needed.
 
 
Education and Experience: Successful completion of an approved Certified Nursing Assistant (CNA) program or successful completion of a Medical Assisting (MA) program, or completion of School of Nursing Fundamentals required. Minimum six months nursing assistant or MA experience preferred.
 
 
Knowledge and Skills: Demonstrates competencies in fundamentals of patient care and knowledge of scope of practice for unlicensed healthcare team members. Exhibits strong customer service skills. Able to read, write legibly and speak in English (and Spanish preferred) with professional quality; use computer, printer and software programs necessary to the position, e.g., Word, Outlook, organization electronic medical record; perform basic non-licensed patient care activities; comprehend and follow-through with instructions; relate and communicate positively, effectively and professionally with others; be assertive and consistent in following and enforcing policies; work calmly and respond courteously when under pressure; collaborate; accept direction; think critically and use good judgment; work independently with minimal supervision; perform basic math functions; compose written material; manage multiple assignments effectively; organize and prioritize workload; problem solve; recall information with accuracy; pay close attention to detail; distinguish colors and smells as necessary for patient care; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the work place and patient care; see adequately to read computer screens, medical records and written documents necessary to position; discern temperature variances through touch. 
 
Licensures and Certifications: Basic Life Support (BLS) certification issued by the American Heart Association required.

Patient Care Assistant ~ 15A Surgical & Trauma Care Unit Adult

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