- Evolent Health (Columbus, OH)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The ** Coordinator , Intake Utilization Management ** at Evolent will serve as a ... regulatory requirements, and client contractual agreements. **Collaboration Opportunities** : The Coordinator , Intake Utilization Management reports directly… more
- ManpowerGroup (Rancho Cucamonga, CA)
- **Job Title: Utilization Management Outpatient** **Duration: 6 months** **Location: Rancho Cucamonga, CA (Hybrid, Twice in a month)** **Pay rate: $23.98/hr.** ... **We are looking for an Utilization Management Outpatient** **to join one of...standards for appropriate authorizations of referrals at the UM Coordinator level. + Responsible for representing the Inland Empire… more
- Conviva (Tallahassee, FL)
- …UM Administration Coordinator - Phone Intake contributes to administration of utilization management . The UM Administration Coordinator performs varied ... Shift Hours - 8a - 5 The UM Administration Coordinator - Phone Intake provides non-clinical support for the...or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization , preferably within… more
- Trinity Health (Pontiac, MI)
- …customers and community groups. **D.** **Experience** Three years recent acute care utilization management experience. Knowledge of regulations relative to ... RN licensure within the State of Michigan. Certified Professional in Utilization Review/ Management preferred. **C** **Special Skill / Aptitudes** Understanding… more
- Fallon Health (Worcester, MA)
- **Overview** **The Authorization Coordinator works M - F 8 am to 5 pm/ 8:30 am to 5 pm and will require at least 6 months of training 5 days/week in the office ... NCQA standards, other applicable regulatory requirements, and customer expectations. The FH Authorization Coordinator serves to administer the FH prior … more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. Under the direction of the Utilization Management , Assistant Manager, you will play a key role in processing and ... leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise...managing authorization requests. You will: + Receive urgent, routine, pre-service,… more
- VNS Health (Manhattan, NY)
- …+ Advanced personal computer skills, including Word, Excel or Access required + Utilization Management experience preferred CAREERS AT VNS Health The future of ... authorization requests and/or activities + Communicates with Care Management , Member Services, Membership and Eligibility and other internal departments… more
- Prime Healthcare (Boonton Township, NJ)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/173490/ utilization -review- coordinator -%28ft%29/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... for contacting external case managers and managed care organizations for pre- authorization , concurrent reviews and appeals/denials management throughout the… more
- Spokane County (Spokane, WA)
- …Behavioral Health Administrative Services Organization Utilization Review Integrated Care Coordinator : + Performs utilization management , utilization ... practice standards for substance use disorder assessment and treatment. + Knowledge of utilization management of public behavioral health. + Knowledge of federal… more
- Tenet Healthcare (Detroit, MI)
- …of care and appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. (5% daily, ... national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention… 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
- Amentum (Seattle, WA)
- …+ Lab Space and Facility utilization support, walkdowns and updates. As the Asset Management Move Coordinator you will be expected to: + Work in a team ... is looking for you! We are seeking an Asset Management Move Coordinator for our client site...+ Must be able to obtain and maintain facility credentials/ authorization . Note: US Citizenship or Permanent Residency is required… more
- Baptist Memorial (Memphis, TN)
- …include status management , medical necessity reviews, verification of authorization , resource utilization , and denial prevention. Responsibilities + ... Summary The Utilization Review Nurse is responsible for evaluating the...queues in the electronic medical record + Communicates with authorization coordinator + Communicates in-house high dollar… more
- ChenMed (Glenwood, IL)
- …market leaders, external clients and HMO to establish, maintain and support outpatient utilization management in PMR and delegated utilization management ... necessary. **_Other responsibilities may include:_** + Drive the current delegated/non-delegated utilization management model to a sustainable and reproducible… more
- Select Medical (Frisco, TX)
- …within Select Medical to include but not limited to CEO, DBD, CLs, Admissions Coordinator and Case Management team that may help grow relationships and impact ... venture with Select Medical & Baylor Scott & White Health **Prior Authorization Specialist -** **onsite only** **This position must work** **onsite** **at** **Baylor… more
- Robert Half Office Team (Bakersfield, CA)
- …consistent with policies and procedures as described in the Utilization Management plan. The Clinical Administrator Coordinator role offers a long-term ... the utilization management team in maintaining and managing the utilization processes for pre-service authorization requests in a timely and accurate… more
- University of Miami (Coral Gables, FL)
- …Functions + Responsible for the Department of Orthopaedics OR (operating room) management . This includes monitoring, maintaining, and improving utilization and ... is currently seeking a full time Sr. Clinical Program Coordinator to work in Coral Gables, FL. The Senior...authorization approval for surgical cases received, and OR utilization protocols where needed. + Train department surgical schedulers… more
- Elevance Health (Overland Park, KS)
- …LTSS/IDD), behavioral health or physical health needs. + Submits utilization / authorization requests to utilization management with documentation ... to, potential for high-risk complications). + Engages the primary service coordinator and other clinical healthcare management and interdisciplinary teams… more
- Centers Plan for Healthy Living (Margate, FL)
- …with the guidance and plans they need for healthy living. JOB SUMMARY: The Utilization Management Care Coordinator works within a multidisciplinary care team ... UM Coordinator 5297 W Copans Rd, Margate, FL 33063,...in our Managed Long Term Care program and facilitate authorization requests for eligible members. PRIMARY RESPONSIBILITIES: + Assists… more
- HCA Healthcare (Aurora, CO)
- …including discharge planning. + You will oversee utilization management process including verification of insurance coverage, pre- authorization , resource ... The typical candidate is hired below midpoint of the range. **Rehab Case Coordinator ** **RN or MSW are being considered** **RN pay range $39.68- 48.21-… more
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