- 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 Qualifications: One (1) ... 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
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The RN Utilization Management Nurse Coordinator is responsible for both concurrent and ... utilization requirements and 3rd party payor contracts. The UM department is responsible for LOS and Level of...to meet targets. + Participates in all aspects of utilization management . Assist with strategies, plans and… more
- Sharp HealthCare (San Diego, CA)
- …Care Coordinator , under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests for outpatient ... SCMG operation documents as appropriate for approval at the UM Care Coordinator level of review.Appropriately identify...related to the position.Bring to attention of the Supervisor, Utilization Management Care Coordinators, and UM… more
- Catholic Health Services (Melville, NY)
- … and Appeals Coordinator will perform activities to help facilitate utilization management and appeals functions to include coordination of specific process ... payment related activities. Position Responsibilities: | Prepares necessary documentation for utilization management and appeals processes, performs data … more
- HonorHealth (Scottsdale, AZ)
- …Director of Care Coordination and Clinical Value, assists in the administration of Utilization Management functions to include, but not limited to, organization ... up, research, and report creation. The position primarily supports UM operations and communication with payers, in order to...peer to peer review with payer as directed. Retrieves utilization management clinical requests and handles each… more
- Covenant Health Inc. (Louisville, TN)
- Overview Utilization Review Coordinator , Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Peninsula Overview: Peninsula, a division of ... budgeted targets. + Provides medical/psychiatric leadership/consultation to Provider Relations, Medical Utilization Management , and Quality Management Staff… more
- University of Miami (Miami, FL)
- …Radiology Administration has an exciting opportunity for a full time Clinical Program Coordinator to work at Desai Sethi Medical Center in Miami. The incumbent ... records on program activities, progress, status or other special reports for management or outside agencies.* Maintains patient confidentiality as well as the… more
- University of Miami (Miami, FL)
- …Radiology Administration has an exciting opportunity for a full time Clinical Program Coordinator to work at Desai Sethi Medical Center in Miami. The incumbent ... and flyers. + Prepares periodic reports, financial statements, and records for management or outside agencies. + Maintains patient confidentiality as well as the… more
- Dignity Health (Santa Cruz, 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
- 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
- Dignity Health (Los Angeles, 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
- Dignity Health (Phoenix, AZ)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... the Hospital. **Job Summary / Purpose** The RN Care Coordinator is responsible for overseeing the progression of care...+ Collaborate effectively with multiple stakeholders + Understand how utilization management and case management … more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... bonus eligibility, and more! **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and… more
- Virginia Mason Franciscan Health (Burien, WA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... FTE- min 0.6 FTE required) **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge… more
- Community Based Care of Brevard, Inc. (Rockledge, FL)
- …develop an individualized case plan outlining family needs, goals and services. Service Utilization UM /Wrap: This is strongly recommended in order to manage and ... Starting Salary: $45,000/year Position Summary: The Diversion Care Coordinator will be responsible for managing a caseload...application for daily entry of case activity and the utilization management of service authorizations. 2+ years'… more
- AmeriHealth Caritas (Charleston, SC)
- …the CSHCS/SSI conversion application process by working closely with member, providers, Utilization Management ( UM ), and the local Medicaid office ... it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other… more
- Corewell Health (Trenton, 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
- Corewell Health (Royal Oak, 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
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