- ManpowerGroup (Columbia, SC)
- + **Title:** Managed Care Coordinator UM II + **Location:** Initial on-site work required for the first week, followed by remote work. + **Hours:** ... determine medical necessity and contract benefits. + Collaborate with Care Management and other areas for timely care... Care Management and other areas for timely care management execution. + Manage assigned members and authorizations… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role The UM Coordinator Supervisor manages the daily operations of the UM Coordinator team providing direct guidance and support with ... support the plan's clinical operations. The Supervisor of the UM Coordinator reports to the UM...skills. * Previous knowledge of plan authorization activities and managed care procedures and workflows strongly preferred.… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …regarding their requests for preservice, prospective, and concurrent reviews. The Senior UM Coordinator reports to the Manager, Utilization Management and/or ... Function as a SME (subject matter expert) for the UM Coordinator Team. + Support training of...+ History working in medical records review, healthcare, or managed care organizations. About At Brighton Health… more
- Humana (Columbus, OH)
- …support assignments. Performs computations. Typically works on semi-routine assignments. As a UM Coordinator you will be responsible for taking prior ... requests, and this may require outbound calls to providers offices. As a UM coordinator you will be collecting clinical information and reviewing resources… more
- Humana (Columbus, OH)
- …of experience with Utilization Review and/or Prior Authorization, preferably with a managed care organization + Proficient utilizing electronic medical record ... a part of our caring community and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization management. The … more
- Humana (Columbus, OH)
- …Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization. **Additional Information** + **Workstyle:** This is ... first** Humana Healthy Horizons in Kentucky is seeking a UM Administration Coordinator 2 who will contribute...policies and procedures ensuring best and most appropriate treatment, care or services for members. + Decisions are typically… more
- Centers Plan for Healthy Living (Staten Island, NY)
- UM Care Coordinator 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #12102 Tuesday, November 5, 2024 Centers Plan for Healthy Living's goal is to create ... guidance and plans they need for healthy living. JOB SUMMARY: The Utilization Management Care Coordinator works within a multidisciplinary care team to… more
- LA Care Health Plan (Los Angeles, CA)
- Enhanced Care Management Coordinator II Job Category:...with at least 1 year of experience in Medi-Cal managed care and/or as a Medical Assistant. ... to support the safety net required to achieve that purpose. Job Summary The Enhanced Care Management (ECM) Coordinator II provides a broad range of project and… more
- Dignity Health (Northridge, CA)
- …Accredited Case Manager (ACM-RN), or UM Certification preferred. + Knowledge of managed care and payer environment preferred. + LA City Fire Card required ... Visit dignityhealth.org/northridgehospital (https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Case Manager ( Care Coordinator ) Case Manager Northridge Hospital Medical… more
- Dignity Health (Long Beach, CA)
- …Accredited Case Manager (ACM-RN) or UM Certification preferred + Knowledge of managed care and payer environment preferred. **Pay Range** $53.01 - $66.19 ... both inside our hospitals and out in the community. **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …vacation, adoption assistance, annual bonus eligibility, and more! **Responsibilities** The Care Coordinator RN is responsible for overseeing the progression ... discharge planning for identified patients requiring these services. The Care Coordinator RN performs this role to...Able to apply clinical guidelines to ensure progression of care . + Knowledge of managed care… more
- Catholic Health Initiatives (Omaha, NE)
- **Overview** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these ... services. The RN Care Coordinator performs this role to meet...Able to apply clinical guidelines to ensure progression of care . + Knowledge of managed care… more
- Dignity Health (Los Angeles, CA)
- …Accredited Case Manager (ACM-RN), or UM Certification preferred + Knowledge of managed care and payer environment preferred. This position is represented by ... systems. Visit https://www.dignityhealth.org/socal/locations/californiahospital for more information. **Responsibilities** The RN Care Coordinator is responsible for overseeing the… more
- University of Michigan (Ann Arbor, MI)
- … Coordinator to coordinate and facilitate communication between referring physicians, managed care plans, clinic personnel, distance referral locations and ... Patient Services Intermediate, Referral Coordinator for Cardiac Rehabilitation Apply Now **How to...with patient education related to the special requirements of Managed Care Plans. + Respond to patient… more
- ManpowerGroup (Rancho Cucamonga, CA)
- …for meeting accuracy standards for appropriate authorizations of referrals at the UM Coordinator level. + Responsible for representing the Inland Empire ... other matters pertinent to processing authorization requests or other UM related correspondence. + Assist Management or Utilization Management...+ Requires knowledge of ICD-9/10 and CPT codes + Managed Care or physician office a must… more
- Sharp HealthCare (San Diego, CA)
- …settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience with InterQual or Milliman Guidelines. ... to acute or visit to the Emergency Department.Informs Director, QI/ UM of any quality issues.Attends hospitalists rounds, as required,...and current standards of clinical practice. + Knowledge of managed care and Health Plan contracts. +… more
- Catholic Health Initiatives (Omaha, NE)
- …UM Certification preferred + Able to apply clinical guidelines to ensure progression of care . + Knowledge of managed care and payer environment preferred. ... Medical Center - Bergan Mercy our focus is patient-centered care . Our level I trauma center and academic medical...of medical services includes trauma services heart and vascular care emergency services surgery maternity cancer care … more
- Covenant Health Inc. (Louisville, TN)
- …have exceptional oral and written communication skills. Previous successful experience in managed care management is desired. Licensure Requirement: Current RN ... Overview Utilization Review Coordinator , Quality Management Full Time, 80 Hours Per...Knox, Blount, Loudon and Sevier Counties. Additionally, Peninsula offers care specifically designed for seniors with co-existing psychiatric and… more
- Banner Health (AZ)
- …Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options ... years experience in healthcare as a Nursing Asst, Medical Asst, Health Unit Coordinator , Patient Care Tech, etc. Requires an understanding of medical… more
- UCLA Health (Los Angeles, CA)
- …experience managing staff in a healthcare environment + Two or more years of managed care or health plan experience preferred + Experience processing ambulatory ... will be responsible for assisting with the day-to-day management of the UM department and coordinators. This will involve coordinating staff schedules to efficiently… more