- Hackensack Meridian Health (Belle Mead, NJ)
- …to transform healthcare and serve as a leader of positive change. The Utilization Management Coordinator utilizes clinical knowledge and understanding of ... appropriate alternative level of care setting for continued treatment. Employs the utilization management process to assist in setting priorities, planning,… more
- Humana (Columbus, OH)
- …the department. We are the beginning, middle and end of processes for utilization management . This role partners with leadership, Medical Directors, Nurses and ... **Become a part of our caring community and help us put health first** The UM Administration Coordinator 2 provides clerical support for… more
- Humana (Columbus, OH)
- …first** The UM Administration Coordinator 2 contributes to administration of utilization management . The UM Administration Coordinator 2 performs ... support assignments. Performs computations. Typically works on semi-routine assignments. The UM Administration Coordinator 2 provides non-clinical support for… more
- Centers Plan for Healthy Living (Margate, FL)
- UM Coordinator 5297 W Copans Rd, Margate,...plans they need for healthy living. JOB SUMMARY: The Utilization Management Care Coordinator works within ... a multidisciplinary care team to assist with the care of members enrolled in our Managed Long Term Care program and facilitate authorization requests for eligible members. PRIMARY RESPONSIBILITIES: + Assists in the prior authorization of services and ongoing… more
- Apex Health Solutions (Houston, TX)
- …or Licensed Vocational Nurse required and current unrestricted Certification in Utilization Review/ Utilization Management preferred Experience / Knowledge ... and resource person to Health Solutions' members for the utilization review (UR) of healthcare services. The UM...flags cases for review by the Appeals & Outcomes Coordinator *Reports potential risk management cases or… more
- Children's Hospital & Research Center Oakland (Oakland, CA)
- …of the Supervisor, Financial Counseling and UM is to supervise the Utilization Management and Financial Counselors activities to insure a payor source is ... daily admissions and coordinates any clinical payer concerns with the Utilization management department. Demonstrates overall improved Revenue Cycle performance… more
- Conviva (Tallahassee, FL)
- …UM Administration Coordinator - Phone Intake contributes to administration of utilization management . The UM Administration Coordinator performs ... support assignments. Performs computations. Typically works on semi-routine assignments. The UM Administration Coordinator - Census Management . Responsible… more
- ManpowerGroup (Rancho Cucamonga, CA)
- …authorization requests or other UM related correspondence. + Assist Management or Utilization Management Nurses as requested. **Qualifications:** ... **Job Title: Utilization Management Outpatient** **Duration: 6 months**...accuracy standards for appropriate authorizations of referrals at the UM Coordinator level. + Responsible for representing… more
- Dignity Health (Northridge, CA)
- …than 400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for ... appropriate care transition and discharge process when not performing UM role + The UMC participates regularly in Medical...+ Current CA Registered Nurse (RN) license + Prior Utilization Management experience in a clinical or… more
- Huron Consulting Group (Chicago, IL)
- …as the expert you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate ... to facilitate optimal patient outcomes while managing healthcare costs. The Utilization Management Specialist ensures compliance with regulatory requirements and… more
- Commonwealth Care Alliance (Boston, MA)
- …services, procedures, and facilities under the provisions of CCA's benefits plan. The Utilization Management ( UM ) Specialist is responsible for applying ... Providers. The UM Specialist reports to the Utilization Management Nurse Manager. **What You'll Be...or experience as a medical coder, medical billing, Insurance Coordinator or other relevant clinical background highly preferred +… more
- Access Dubuque (Dubuque, IA)
- …self- management education. ** Utilization Management /Revenue Cycle** + Applies the utilization management ( UM ) plan by functioning in the UM ... RN-Care Coordinator **UnityPoint Health Finley Hospital** 1 Positions ID:...planning and executing a safe discharge. + Collaborate with Utilization Management team on continued stay review.… more
- Cedars-Sinai (Beverly Hills, CA)
- **Job Description** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all ... team members of Utilization Management , Patient and Provider Services, Claims Department and other...beyond. **Req ID** : 4556 **Working Title** : Case Management Coordinator - Inpatient Specialty Program **Department**… more
- University of Miami (Miami, FL)
- …. The University of Miami is currently seeking a Clinical Program Coordinator to work at Desai Sethi Medical Center in Miam. The incumbent ... are processed and reported in a timely manner. In addition, the coordinator will assist in monitoring the performance of artificial intelligence (AI) algorithms… more
- Dignity Health (Northridge, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. +… more
- Blue KC (MO)
- …and pharmacy benefit drug claims research and review as well as drug utilization management including prior authorization, step therapy, quantity limits, etc. ... with pharmaceutical industry representatives as well as the Medical and Pharmacy Management Committee. + Executes utilization management program according… more
- Dignity Health (Carmichael, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... Hip- and Knee- Replacement. **Responsibilities** **Per Diem RN Care Coordinator ** The RN Care Coordinator is responsible...guidelines to ensure progression of care. + Understanding how utilization management and case management … more
- Catholic Health Initiatives (Council Bluffs, IA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... **Overview** The RN Care Coordinator is responsible for overseeing the progression of...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Virginia Mason Franciscan Health (Seattle, WA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and ... effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. +… more
- Dignity Health (Long Beach, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. +… more