- Integra Partners (Troy, MI)
- …) Coordinator Supervisor oversees the day-to-day operations and performance of the UM Coordinator team. This position ensures that all intake, triage, and ... teamwork across the department. Salary: $65,000/annual JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES UM Coordinator Supervisor responsibilities include but are… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role The UM Coordinator is responsible for coordinating all aspects of the prior authorization process, including member eligibility and ... members of the organization. Primary Responsibilities + Research and confirm authorization requirements and communicate to member, providers, and facility staff. +… more
- Centers Plan for Healthy Living (Margate, FL)
- …authorization requests for eligible members. PRIMARY RESPONSIBILITIES: + Assists in the prior authorization of services and ongoing authorization requests ... 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… more
- US Tech Solutions (Boston, MA)
- Respond to provider queries, enter administrative authorization data into the computer system, and maintain proper documentation and files to support care of ... - what you will be doing:** + Receives incoming authorization requests from providers, via fax, portal & telephone...event or transaction by lines of business for the UM teams to review and decision requests + Contacts… more
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the clinical team ( UM Nurses/Medical Director) with administrative and non-clinical tasks related to processing ... Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES +...Maintaining expected timelines EXPERIENCE: + 1 year as a UM Coordinator in a managed care payer… more
- Fallon Health (Worcester, MA)
- …of purpose** : Under the direction of the Manager of Prior Authorization , communicates with contracted and non-contracted facilities/agencies/providers to ... collect pertinent prior authorization request data and disseminates information...incoming calls from the multiple ACD lines for the UM department addressing and/or referring customer (provider/member) calls/inquiries, provide… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Blue Cross and Blue Shield of Minnesota Position Title: Health Support Coordinator Location: Remote Career Area: Customer Service/Operations About Blue Cross and ... to make a difference, join us. The Impact You Will Have The Health Support Coordinator (HSC) is a member of the Blue Cross Blue Shield of Minnesota (BCBSMN) Care… more
- University of Southern California (Alhambra, CA)
- …patients to validate that the appropriate patient status is assigned upon admission and prior to discharge; InterQual or MCG reviews are completed within 24 hours of ... utilizing data from multiple sources, as supported by the ambulatory care coordinator . 4. Analyze and interpret data in collaboration with patient, family,… more
- Adecco US, Inc. (Minneapolis, MN)
- …authorizations submitted by providers within the designated turnaround times specified in the Prior Authorization List for all lines of business, including RMHP ... RMHP CHP+, RMHP IFP, and NHP RAE Medicaid + When processing authorization requests, the Clinical Coordinator applies approved medical necessity criteria… more
- Highmark Health (Pittsburgh, PA)
- …administration of effective and efficient processing for pharmacy benefits prior authorization processes, insurance evaluations, addressing patient medication ... medication reconciliation, and overseeing referral screening/management. **ESSENTIAL RESPONSIBILITIES** + Prior Authorization & Utilization Management: Reviews pharmacy… more