- ProMedica Health System (Toledo, OH)
- …RESPONSIBILITIES This position reports to the Manager of Access POSITION SUMMARY As a Utilization Management Nurse in the Capacity Command Center, you will play ... about best practices, industry trends, and regulatory changes related to utilization management and healthcare delivery. Participate in ongoing education… more
- Centers Plan for Healthy Living (Staten Island, NY)
- UM Care Coordinator 75 Vanderbilt Ave,...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… more
- Apex Health Solutions (Houston, TX)
- …or Licensed Vocational Nurse required and current unrestricted Certification in Utilization Review/ Utilization Management preferred Experience / Knowledge ... 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
- 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
- Children's Hospital & Research Center Oakland (Oakland, CA)
- …of the Supervisor, Financial Counseling and UM is to supervise the Utilization Management and Financial Counselors activities to insure a payor source is ... daily admissions and coordinates any clinical payer concerns with the Utilization management department. Demonstrates overall improved Revenue Cycle performance… more
- Trinity Health (Darby, PA)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The Appeals and Utilization Management Coordinator under direction and in collaboration ... process for the THMA South hospitals. The Appeals and Utilization Management Coordinator ensures the...and state laws, and department policies + Collaborates with UM Manager to establish efficient workflow processes to ensure… more
- YesCare Corp (Bartow, FL)
- …Veterans._ **Responsibilities** Below is a list of your responsibilities as a ** Utilization Management Coordinator ** with YesCare: + Confirms admissions ... with outside hospitals and notifies the Utilization Management Department of need to report...providers for authorization numbers + Forwards daily inpatient case management abstracts to Corporate UM + Reviews… more
- Dignity Health (Northridge, CA)
- …than 400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for ... appropriate care transition and discharge process when not performing UM role + The UMC participates regularly in Medical...+ Current CA Registered Nurse (RN) license + Prior Utilization Management experience in a clinical or… more
- Huron Consulting Group (Chicago, IL)
- …as the expert you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate ... to facilitate optimal patient outcomes while managing healthcare costs. The Utilization Management Specialist ensures compliance with regulatory requirements and… more
- Access Dubuque (Dubuque, IA)
- …self- management education. ** Utilization Management /Revenue Cycle** + Applies the utilization management ( UM ) plan by functioning in the UM ... RN-Care Coordinator **UnityPoint Health Finley Hospital** 1 Positions ID:...planning and executing a safe discharge. + Collaborate with Utilization Management team on continued stay review.… more
- University of Miami (Miami, FL)
- …. The University of Miami is currently seeking a Clinical Program Coordinator to work at Desai Sethi Medical Center in Miam. The incumbent ... are processed and reported in a timely manner. In addition, the coordinator will assist in monitoring the performance of artificial intelligence (AI) algorithms… more
- Catholic Health Initiatives (Omaha, NE)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... **Overview** The RN Care Coordinator is responsible for overseeing the progression of...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Ventura County (Ventura, CA)
- …part of the care team, working as a liaison between the patient, providers, utilization management and various departments to ensure timely access to specialty ... close the loop after appointment. + Collaborates with Medical Management , UM and health plans to resolve...clinical staff with questions and redirects in conjunction with utilization management and medical management .… 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
- Virginia Mason Franciscan Health (Federal Way, WA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... + Sign on Bonus available **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... + Sign on Bonus available **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge… more
- Bassett Healthcare (Cooperstown, NY)
- …principle liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate bed is ... care appropriate to each patient. Clinical and Technical Responsibilities: Provides case management services as appropriate throughout the life span and in various… 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
- 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
- Catholic Health Initiatives (Chattanooga, TN)
- …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
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