- Conviva (Tallahassee, FL)
- …UM Administration Coordinator - Phone Intake contributes to administration of utilization management . The UM Administration Coordinator performs varied ... Shift Hours - 8a - 5 The UM Administration Coordinator - Phone Intake provides non-clinical support for the...resolution/inquiries from member and/or providers. **This role is and Remote opportunity only within the following states: TX, FL,… more
- Hackensack Meridian Health (Neptune, NJ)
- …and serve as a leader of positive change. The **Care Management , Care Coordinator , Utilization Management ** is a member of the healthcare team and ... treatment. Accountable for a designated patient caseload; the Care Coordinator , Utilization Management plans effectively...New Jersey regulations for Nursing **.** **This is a remote , night shift position. The schedule for this role… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** Humana is seeking a Utilization Management (UM) Coordinator to join the Wisconsin Medicaid Market ... team. The UM Coordinator provides non-clinical support for policies and procedures related...for policies and procedures related to the administration of utilization management , ensuring the best and most… more
- Actalent (Santa Barbara, CA)
- …+ Flexible to work a 3-month contract + Medi-Cal Experience + Utilization Management WHAT'S IN IT FOR YOU: + Remote opportunity + Gain experience with ... Non-profit healthcare network is looking for a utilization management registered nurse to join...a leading healthcare organization Description: The Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned… more
- Elevance Health (Overland Park, KS)
- …(such as LTSS/IDD), behavioral health or physical health needs. + Submits utilization /authorization requests to utilization management with documentation ... **Location: This position is remote work from home but candidates must be...potential for high-risk complications). + Engages the primary service coordinator and other clinical healthcare management and… more
- Trinity Health (Livonia, MI)
- …Certified Application Coordinator or Professional Billing Claims Certified Applicaiton Coordinator ** REMOTE : position allows for work remote ... Coordinator or Resolute Professional Billing Certified Application Coordinator experience highly preferred** **POSITION PURPOSE** Responsible for providing… more
- Elevance Health (Latham, NY)
- …**LTSS Service Coordinator - RN Telehealth** is responsible for overall management of member's case within the scope of licensure; provides supervision and ... - RN Telehealth** _Location:_ While this position is remote , candidate must reside in tri-state area (NY, NJ,...with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator , Case Management , or similar role; or… more
- Amergis (Los Angeles, CA)
- Amergis Healthcare Staffing is seeking a Quality Improvement Coordinator responsible for analyzing, developing, monitoring and implementing clinical initiatives to ... + Audits medical records and monitors performance measures for health care risk management , sentinel events and trends + Oversees and monitors the development and… more
- Elevance Health (Houston, TX)
- **LTSS Service Coordinator - Auditor ( Remote in Indiana/Texas)** **Location:** While remote , candidates will ideally be located within 50 miles of one of our ... Elevance Health PulsePoints in Indiana or Texas. The **LTSS Service Coordinator -Auditor** is responsible for auditing member individual service plans within the… more
- Providence (Vancouver, WA)
- …of Care Planning, Discharge Planning, Coordination of Outpatient Care) + Utilization Management Experience (EX. Concurrent Review, Prior Authorization, Medical ... them.** **Providence Health Plan is calling a Clinical Program Coordinator RN who will:** + Provide care coordination, case... RN who will:** + Provide care coordination, case management and care management services to Providence… more
- The Cigna Group (Bloomfield, CT)
- …years of clinical experience in acute care, managed care, ER, ICU, or clinical utilization management ** + Home health, SNF, and/or rehab experience desired + ... clinical and operational processes related to transition / coordination of care and utilization / case management of Post-Acute Care services including but not… more
- Magellan Health Services (Pocatello, ID)
- …Healthcare-related field, or relevant experience in lieu of degree., Experience in utilization management , quality assurance, home or facility care, community ... in analyzing trends based on decision support systems. Business management skills to include, but not limited to, cost/benefit...and service agency contacts. General Job Information Title Care Coordinator - Tribal Outreach Liaison ( Remote in… 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
- Trinity Health (Livonia, MI)
- …It will focus on Payer Claims Inbound to Epic using DINE, Roster Management Engine (RME), configuring new payer data sources, and working and managing claims ... highly preferred._** **_* This position allows for work from home/ remote opportunity_** **ESSENTIAL FUNCTIONS** Knows, understands, incorporates and demonstrates the… more
- Veterans Affairs, Veterans Health Administration (Cleveland, OH)
- …VA Northeast Ohio Healthcare System is recruiting for a Registered Nurse - Risk Management Investigations Coordinator . The Registered Nurse - Risk Management ... will function in Quality Managements Service. Responsibilities The Investigation Coordinator , Registered Nurse takes guidance from the Chief of Consolidated… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …The Senior Project Coordinator is results driven and through advanced utilization of project management knowledge areas and experience, complex projects are ... Coordinator possesses advanced knowledge and experience of project management fundamentals. This advanced knowledge and experience allows the Senior Project… more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- …acquisition and support services required by project managers, program managers, upper management and stakeholders on all aspects of procurement for a wide variety ... of items to include specialized services. Responsibilities As the Acquisition Utilization Specialist you will serve as the medical center liaison and advisor on… more
- CVS Health (Westminster, MD)
- …and procuring community resources and durable medical supplies. The Care Coordinator tracks population disease management practices, commits to recognize ... states and 950+ locations across the country. Under the remote supervision of a clinical operation leader and local...clinical operation leader and local leader, the Retail health coordinator will communicate with plan and retail health identified… more
- Robert Half Office Team (Bakersfield, CA)
- …consistent with policies and procedures as described in the Utilization Management plan. The Clinical Administrator Coordinator role offers a long-term ... Coordinator , you will be responsible for providing non-clinical support to the utilization management team in maintaining and managing the utilization … more
- Veterans Affairs, Veterans Health Administration (Prescott, AZ)
- Summary The Social Worker (Program Coordinator ) serves at the GS-12 grade level and is administratively responsible for the Spinal Cord Injury and Disorder (SCI) ... limited to the following: Provide supportive services and case management services to Veterans seeking SCI services and have...supporting the behavioral health needs of those in crisis. Coordinator will collaborate with the other members of the… more