• UM Administration Coordinator

    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
    Humana (03/15/25)
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  • UM Administration Coordinator

    Humana (Baton Rouge, LA)
    …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
    Humana (03/13/25)
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  • UM Coordinator

    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
    Centers Plan for Healthy Living (03/04/25)
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  • UM Reviewer

    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
    Apex Health Solutions (03/09/25)
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  • Utilization Management

    Rady Children's Hospital San Diego (San Diego, CA)
    JOB SUMMARY: Under the supervision of the Utilization Management ( UM ) Operations Supervisor, the UM Coordinator I's primary job function is to ... the provider call center lines), and appropriately processing required UM notifications (letters, faxes, etc.). MINIMUM QUALIFICATIONS: HS Diploma,GED,or Equivalent… more
    Rady Children's Hospital San Diego (03/04/25)
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  • CHS Utilization and Appeals…

    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
    Catholic Health Services (02/14/25)
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  • Utilization Review Coord

    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
    Covenant Health Inc. (01/31/25)
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  • Clinical Program Coordinator

    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 (01/28/25)
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  • Clinical Program Coordinator - Radiology

    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
    University of Miami (03/04/25)
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  • RN Patient Care Coordinator Per Diem

    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
    Dignity Health (02/15/25)
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  • RN Patient Care Coordinator Per Diem

    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
    Dignity Health (03/04/25)
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  • RN Care Coordinator

    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 (02/07/25)
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  • RN Care Coordinator

    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 (02/05/25)
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  • Quality Management Appeals and Grievances…

    UCLA Health (Los Angeles, CA)
    Description The Appeals & Grievance Intake Coordinator serves as the primary point of contact for receipt of member-initiated complaints and Health Plan grievances ... and appeals. The Grievance and Appeals Intake Coordinator is responsible for managing the grievances and appeals shared email inbox and fax portal of received… more
    UCLA Health (03/04/25)
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  • Care Coordinator RN

    Virginia Mason Franciscan Health (Gig Harbor, 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 (03/10/25)
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  • Care Coordinator RN

    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 (01/31/25)
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  • Diversion Care Coordinator

    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
    Community Based Care of Brevard, Inc. (01/08/25)
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  • RN Care Coordinator

    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 (02/08/25)
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  • RN Care Coordinator

    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
    Corewell Health (02/05/25)
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  • Care Coordinator RN

    Dignity Health (San Bernardino, 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 (02/22/25)
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