- ManpowerGroup (Rancho Cucamonga, CA)
- **Job Title: Utilization Management Outpatient** **Duration: 6 months** **Location: Rancho Cucamonga, CA (Hybrid, Twice in a month)** **Pay rate: $23.98/hr.** ... **We are looking for an Utilization Management Outpatient** **to join one of...standards for appropriate authorizations of referrals at the UM Coordinator level. + Responsible for representing the Inland Empire… more
- Baptist Memorial (Memphis, TN)
- Summary The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization ... services using evidence based criteria. Areas of work include payer notification, authorization management , denial management , escalations, and communication… more
- Trinity Health (Pontiac, MI)
- …customers and community groups. **D.** **Experience** Three years recent acute care utilization management experience. Knowledge of regulations relative to ... RN licensure within the State of Michigan. Certified Professional in Utilization Review/ Management preferred. **C** **Special Skill / Aptitudes** Understanding… more
- Henry Ford Health System (Troy, MI)
- … Coordinator facilitates the operations of the Pharmacy Care Management department by organizing, improving, and implementing pharmacy benefit management ... system, development of new benefit designs and programs, organizing the prior authorization process and management of the various vendor /customer relationships.… more
- Fallon Health (Worcester, MA)
- **Overview** **The Authorization Coordinator works M - F 8 am to 5 pm/ 8:30 am to 5 pm and will require at least 6 months of training 5 days/week in the office ... NCQA standards, other applicable regulatory requirements, and customer expectations. The FH Authorization Coordinator serves to administer the FH prior … more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. Under the direction of the Utilization Management , Assistant Manager, you will play a key role in processing and ... leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise...managing authorization requests. You will: + Receive urgent, routine, pre-service,… more
- Prime Healthcare (Boonton Township, NJ)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/172970/ utilization -review- coordinator -%28pd%29/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... for contacting external case managers and managed care organizations for pre- authorization , concurrent reviews and appeals/denials management throughout the… more
- Sutter Health (Santa Rosa, CA)
- …as appropriate to Managed Care physicians and/or nurses as per the Utilization Management (UM) protocols. Maintains required turnaround times for referral ... completion. Assists providers and patients with referral status questions. Participates in development and implementation of improvements to the referral process and workflows. **Onsite Position** **Job Description** : **EDUCATION:** HS Diploma or GED **SKILLS… more
- Spokane County (Spokane, WA)
- …Behavioral Health Administrative Services Organization Utilization Review Integrated Care Coordinator : + Performs utilization management , utilization ... practice standards for substance use disorder assessment and treatment. + Knowledge of utilization management of public behavioral health. + Knowledge of federal… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Case Management (CM) Coordinator position is a proficient CM representative that provides technical, clerical and data management ... etc. **FINANCE ESSENTIAL FUNCTIONS** + Proactively secures reimbursement/certification and authorization -related needs, independently and escalates to management … more
- Baptist Memorial (Jackson, MS)
- …include status management , medical necessity reviews, verification of authorization , resource utilization , and denial prevention. Responsibilities + ... Summary The Utilization Review Nurse is responsible for evaluating the...queues in the electronic medical record + Communicates with authorization coordinator + Communicates in-house high dollar… more
- Corewell Health (Taylor, MI)
- …of care and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning, and appropriate ... Care Coordinator for Rehab Services PRN/Casual position- hours will...managing a case load of patients that includes facilitating utilization management , and/or care coordination during the… more
- ChenMed (Portsmouth, VA)
- …market leaders, external clients and HMO to establish, maintain and support outpatient utilization management in PMR and delegated utilization management ... necessary. **_Other responsibilities may include:_** + Drive the current delegated/non-delegated utilization management model to a sustainable and reproducible… more
- Elevance Health (Overland Park, KS)
- …LTSS/IDD), behavioral health or physical health needs. + Submits utilization / authorization requests to utilization management with documentation ... to, potential for high-risk complications). + Engages the primary service coordinator and other clinical healthcare management and interdisciplinary teams… more
- Centers Plan for Healthy Living (Margate, FL)
- …with the guidance and plans they need for healthy living. JOB SUMMARY: The Utilization Management Care Coordinator works within a multidisciplinary care team ... UM Coordinator 5297 W Copans Rd, Margate, FL 33063,...in our Managed Long Term Care program and facilitate authorization requests for eligible members. PRIMARY RESPONSIBILITIES: + Assists… more
- Corewell Health (Farmington Hills, MI)
- …of care and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning, and appropriate ... Responsible for managing a case load of patients that includes facilitating utilization management , and/or care coordination during the patient's stay, planning… more
- Tenet Healthcare (Detroit, MI)
- Patient Management Coordinator Healthclub Full Time Days - 2406004039 Description : DMC Rehabilitation Institute of Michigan is one of the nation’s largest ... performs the work of and provides leadership for Patient Access Management operations which includes personnel engaged in scheduling, registration, insurance… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors ... to determine eligibility for services. * Communicate with insurance providers to obtain authorization for services as needed. * Conduct utilization reviews to… more
- Corewell Health (Grosse Pointe, MI)
- …of care and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning, and appropriate ... Responsible for managing a case load of patients that includes facilitating utilization management , and/or care coordination during the patient's stay, planning… more