• 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 (12/03/24)
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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 (12/08/24)
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  • Registered Nurse Coordinator

    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
    Trinity Health (11/29/24)
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  • Care Coordinator - SCMG Utilization

    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
    Sharp HealthCare (02/06/25)
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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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  • Coordinator Utilization

    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
    HonorHealth (02/18/25)
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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 (11/27/24)
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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 Care Coordinator

    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 (12/24/24)
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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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  • RN Care Coordinator

    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
    Dignity Health (01/23/25)
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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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  • Care Coordinator RN

    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
    Virginia Mason Franciscan Health (01/28/25)
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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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  • Coordinator Disability Advocacy Program

    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
    AmeriHealth Caritas (02/13/25)
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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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