- Hackensack Meridian Health (Belle Mead, NJ)
- …resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting ... and serve as a leader of positive change. The Utilization Management Coordinator utilizes clinical knowledge and...transition to alternative levels of care. + Perform concurrent utilization review applying identified criteria at prescribed… more
- Humana (Phoenix, AZ)
- …our caring community and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization management. The UM ... Bachelor's Degree in Business, Finance or a related field + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care… more
- Apex Health Solutions (Houston, TX)
- …a contact and resource person to Health Solutions' members for the utilization review (UR) of healthcare services. The UM Reviewer will be responsible for ... complying with utilization review procedures in accordance with Texas UR Certification requirements,...as part of the preauthorization process; flags cases for review by the Appeals & Outcomes Coordinator … more
- Actalent (Santa Barbara, CA)
- Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a contract basis! Opportunity to gain experience with ... Gain experience with a leading healthcare organization Description: The Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned to one of several… more
- Conviva (Tallahassee, FL)
- … Administration Coordinator - Phone Intake contributes to administration of utilization management. The UM Administration Coordinator performs varied ... semi-routine assignments. Shift Hours - 8a - 5 The UM Administration Coordinator - Phone Intake provides...or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within… more
- Dignity Health (Northridge, CA)
- …care in accordance with and in compliance of the Behavioral Health Dignity Health Utilization Review Policy. + The UMC will participate on the Behavioral Health ... 400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for assessing… 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, ... RN Utilization Review FT Days - 2406003414...an authorization process Closes open cases on the incomplete UM Census Completes the Medicare Certification Checklist on applicable… more
- Huron Consulting Group (Chicago, IL)
- …on established criteria and guidelines. + Maintain accurate and detailed records of review decisions and interactions in the utilization management system. + ... the expert you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate utilization … more
- Access Dubuque (Dubuque, IA)
- …payers to assist in planning and executing a safe discharge. + Collaborate with Utilization Management team on continued stay review . + Educates patients and ... RN-Care Coordinator **UnityPoint Health Finley Hospital** 1 Positions ID:...education. ** Utilization Management/Revenue Cycle** + Applies the utilization management ( UM ) plan by functioning in… more
- Dignity Health (Northridge, CA)
- …and Federal or State regulations pertaining to their practice. + Have an understanding of Utilization Review to progress plan of care. + Performs other duties as ... Certification preferred + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to… more
- Veterans Affairs, Veterans Health Administration (Las Vegas, NV)
- …Care (ensure that request meets criteria) Long Term Acute Care (LTAC) authorization and utilization management ( UM ) follow up at LTAC. Ad-hoc members to ... by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities VA offers a comprehensive total rewards… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …located within hospital + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. Preferred + Bachelor's Degree in Nursing ... adoption assistance, annual bonus eligibility, and more! **Responsibilities** The Care Coordinator RN is responsible for overseeing the progression of care and… more
- Catholic Health Initiatives (Omaha, NE)
- …pertaining to their practice. 13. Performs other duties as assigned, including utilization review as necessary. **Qualifications** + Graduate of an accredited ... **Overview** The RN Care Coordinator is responsible for overseeing the progression of...will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post… more
- Robert Half Office Team (Bakersfield, CA)
- …Requirements Minimum: 1 year of experience performing non-clinical functions for prospective UM review . Preferred: 1 year of experience providing supportive or ... and accurate manner consistent with policies and procedures as described in the Utilization Management plan. The Clinical Administrator Coordinator role offers a… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …to their practice. 13. Performs other duties as assigned, including utilization review as necessary. **Qualifications** **Education and Experience** Required ... bonus eligibility, and more! **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and… more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... our hospitals and out in the community. **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …to their practice. 13. Performs other duties as assigned, including utilization review as necessary. **Qualifications** **Education and Experience** Required ... + Sign on Bonus available **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge… more
- Dignity Health (Los Angeles, CA)
- …90 days of hire. + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... Visit https://www.dignityhealth.org/socal/locations/californiahospital for more information. **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care… more
- Corewell Health (Grosse Pointe, MI)
- …Functions + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). + ... of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + LIC-Registered… more
- ManpowerGroup (Columbia, SC)
- …Bachelor's degree- Nursing. Preferred Work Experience: 7 years-healthcare program management, utilization review , or clinical experience in defined specialty. ... **Title: Coordinator , Managed Care I** **Location: Columbia SC** **Duration:...**Note:-** + Must Have Behavioral Health Experience + Previous Utilization Management ( UM ) or Case Management (CM)… more