- University Health (San Antonio, TX)
- …preferred. Three years recent, full time hospital experience preferred. Work experience in case management, utilization review , or hospital quality assurance ... full description below to get a complete picture of candidate requirements. Care Coordinator will be instrumental in assisting the department and clinicians in the… more
- UnitedHealthcare (Wahiawa, HI)
- …experience * Experience with or exposure to discharge planning * Experience with utilization review , concurrent review and/or risk management * Experience ... health care work better for our patients. In this Health and Social Services Coordinator role, will be an essential element of an Integrated Care Model by relaying… more
- UnitedHealthcare (Kaunakakai, HI)
- …experience * Experience with or exposure to discharge planning * Experience with utilization review , concurrent review and/or risk management * Experience ... care work better for our patients. In this Health and Social Services Care Coordinator role, will be an essential element of an Integrated Care Model by relaying… more
- University Health (Hondo, TX)
- …preferred. Three years recent, full-time hospital experience preferred. Work experience in case management, utilization review or hospital quality assurance ... as a registered nurse is required. National certification in related field is preferred. xrbllit Case Manager Certification (CCM or ANCC) is highly desirable. more
- BroadPath Healthcare Solutions (Tucson, AZ)
- …BroadPath is seeking a highly motivated and results-driven **UM RN Appeals Coordinator .** This role collaborates with clinical review staff, medical ... 8:00 AM - 5:00 PM CST (Flexible) **Responsibilities** A. Performs necessary review to ensure compliance with HHSC and other regulatory entities + Collaborate:… more
- Stanford Health Care (Palo Alto, CA)
- …disease center research portfolio and works with the Clinical Research Coordinator (CRCs) on the implementation, coordination, and documentation of trial specific ... monitors visits, site visits and study close-outs; and collaborates on the review of documentation during protocol audits. + Develops protocol specific Beacon order… more
- Stanford Health Care (Menlo Park, CA)
- …which includes strategic planning, financial performance management, resource utilization , contract administration, operational metrics, lease administration, and ... roles and project expectations, and in conjunction with the project/senior project coordinator serve as the initial point of contact for projects. + Complete… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour)... utilization review including conducting second level review of cases and case referral to a ... to learn more about joining our team as a Utilization Review Nurse Coordinator ! The...utilization review including conducting second level review of cases and case referral to… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40 Hour)... utilization review including conducting second level review of cases and case referral to a ... Campus Hospital (https://portal.ct.gov/dcf/solnit-center/south) - is accepting applications for a Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and ... timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and...potential denials, utilizing input from the Utilization Review Clinical Specialist. + Monitors and updates case… more
- Devereux Advanced Behavioral Health (Viera, FL)
- …our team where you can take your career to the next level. **Being the Utilization Review Coordinator at Devereux has its Advantages!** Devereux Florida is ... to less restrictive environments with ongoing family involvement and support. As the Utilization Review Coordinator at Devereux Florida, you will work… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case ...level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator ... case basis. This position integrates national standards for case management scope of services including: Utilization ...level of care based on Medical Necessity and submits case for Secondary Physician review per Tenet… more
- Sharp HealthCare (San Diego, CA)
- …every patient identified per departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the Case ... home health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care...quality of care issues encountered in the course of review .Serves as a resource for staff (as needed), and… more
- The County of Los Angeles (Los Angeles, CA)
- …OPTION I:One year of experience performing the duties of a Utilization Review Nurse* or Medical Service Coordinator , CCS.** -OR- OPTION II: Two (2) ... Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose… more
- Trinity Health (Columbus, OH)
- … Management extender would work under the direction of the RN Care Managers, Utilization Review Care Manager and the Social Workers. This position functions with ... **Employment Type:** Full time **Shift:** **Description:** **Senior Coordinator for Case Management, Mount Carmel...in HealthQuest + Communicate information received from payers to utilization review nurse. + Transmit continued stay… more
- St. Peters Health (Helena, MT)
- The Utilization Management RN reports directly to Utilization Review RN Coordinator . The UR RN supports the UR RN Coordinator and other UR team ... are utilized effectively and efficiently; engages the UR RN Coordinator with improvement ideas when deviations of best practice...Nursing licensure in the State of Montana. Certification in Case Management and/or Utilization Review … more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** ... case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review...its regulations may be referred to the Title IX Coordinator , to the Department of Education, Office for Civil… more
- LifeCenter Northwest (Bellevue, WA)
- …Responsibilities + Lead and engage daily with the Organ Utilization Coordinator (OUC) team in donor case operations, developing and implementing advanced ... (OUM) provides strategic leadership and operational oversight for the Organ Utilization Coordinator Team (OUCT), directing key aspects of abdominal organ… more
- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... About What You Will be Doing** The RN Care Coordinator is responsible for the case management...case manager assigned to the SNF's for continued review and follow up. + Authorizes all appropriate services… more
- State of Arkansas (Little Rock, AR)
- REHABILITATION COORDINATOR Date: Dec 8, 2025 Req ID: 54562...of all IPEs each year and documents in the case management system and conducts an annual review ... SERVICES Anticipated Starting Salary: $53,557.92 Position Summary The Rehabilitation Coordinator assists individuals with disabilities, injuries, or health conditions… more
