- University Health (San Antonio, TX)
- POSITION SUMMARY/RESPONSIBILITIES Care Coordinator will be instrumental in assisting the department and clinicians in the Ambulatory setting by gathering ... years recent, full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance experience is… more
- University Health (Pleasanton, CA)
- …Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience is ... and the coordination of appropriate diversions to home or other level of care more appropriate for the services needed to be rendered. This position requires… more
- Hackensack Meridian Health (Brick, NJ)
- …to transform healthcare and serve as a leader of positive change. The ** Care Management , Care Coordinator , Utilization Management ** is a member ... of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator , Utilization Management plans effectively in order to… more
- Sharp HealthCare (San Diego, CA)
- … care option if patient does not meet acute or skilled level of care .Communicates with the Quality Management Department regarding any quality of service or ... Chula Vista.** **What You Will Do** To provide discharge planning and coordination of care for members hospitalized in the acute care setting in collaboration… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …with the guidance and 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... of members enrolled in our Managed Long Term Care program and facilitate authorization requests for eligible members.… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251212-5613FP-001 Location East Hartford, CT Date Opened 12/16/2025 12:00:00 AM ... to learn more about joining our team as a Utilization Review Nurse Coordinator ! The State of...workflow and determine priorities to assure highest quality of care with efficient utilization of available services;… more
- CVS Health (Baton Rouge, LA)
- …we do it all with heart, each and every day. **Position Summary** The Utilization Management Coordinator /UMNC assists in ensuring that authorization request ... developed and implemented for vented children, ie generators, housing, rentals) * Collaborate with care management and utilization management teams in… more
- Sanford Health (Sioux Falls, SD)
- …**Department Details** The Intake Coordinator position supports the Health Plan Utilization Management team and assists with members and provider calls ... pm, no weekends or holidays **Job Summary** The intake coordinator serves as a support to health plan teams...members. For individuals supporting clinical areas, additional duties are: Utilization management performs resource benefit policy … more
- Behavioral Center of Michigan (Warren, MI)
- …all state mandated regulations. Maintains compliancy with regulation changes affecting utilization management . Reviews patient recrods and evaluates patient ... Under general supervision, the Utilization Review Coordinator provides professional assessment,...and advises physicians and other departments of regulations affecting utilization management . Consults with Social Services Department… more
- Integra Partners (Troy, MI)
- …Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES ... expectations and functions of the UM team + Time Management What will you achieve in the first 12...expected timelines EXPERIENCE: + 1 year as a UM Coordinator in a managed care payer environment… more
- South Middlesex Opportunity Council (Framingham, MA)
- …casual Working Conditions: As part of the responsibilities of this position, the Utilization Management Coordinator will have direct or incidental contact ... children and families. This position will coordinate billing and monitor utilization review for the Clinic and Residential Recovery Programs. Candidates must… 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 a ... to less restrictive environments with ongoing family involvement and support. As the Utilization Review Coordinator at Devereux Florida, you will work with other… more
- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY: Under the supervision of the Utilization Management (UM) Operations Supervisor, the UM Coordinator I's primary job function is to support UM ... EZ Cap, Word, Outlook, and data entry systems Previous experience in the health care field, such as hospital, medical group, health insurance, or other Risk Bearing… more
- Henry Ford Health System (Troy, MI)
- …and other delegated pharmacist. Facilitates the operations of the Pharmacy Care Management Department by organizing, improving, and implementing pharmacy ... benefit management policies and procedures. Major areas of responsibility include...the equivalent. (October 2004) Additional Information + Organization: Community Care Services + Department: Pharmacy- Utilization Mgmt +… more
- Katmai (Fort Carson, CO)
- …TRICARE Operations Manual (TOM) access to care standards for appropriate utilization of services. Perform utilization management /review for medical ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...the CMHS. **ESSENTIAL DUTIES & RESPONSIBILITIES** + Act as coordinator /liaison with providers, staff and Managed Care … more
- Tenet Healthcare (Detroit, MI)
- …appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. (5% daily, essential) ... coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced...for case management scope of services including: Utilization Management services supporting medical necessity and… more
- The County of Los Angeles (Los Angeles, CA)
- …training is needed, and to make recommendations on potential areas for medical care evaluation studies. + Attends Utilization Review Committee meetings to inform ... community partner clinics. Every year, we deliver compassionate, life-saving care to over 600,000 unique patients across LA County....I:One year of experience performing the duties of a Utilization Review Nurse* or Medical Service Coordinator ,… more
- Community Based Care of Brevard, Inc. (Rockledge, FL)
- Starting Salary: $49,700/year Position Summary: The Diversion Care Coordinator will be responsible for managing a caseload of families served in Non Judicial In ... served in North and Central Brevard County. The Diversion Care Coordinator will coordinate the delivery and...application for daily entry of case activity and the utilization management of service authorizations. 2+ years'… 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 ... supportive liaison and educator to providers and staff around utilization management principles. This professional role will...and high risk screen for the purpose of resource management . 15. Provide point-of- care coaching to the… more
- Humana (Jackson, MS)
- … or discharge planner in an acute care setting + Previous experience in utilization management / utilization review for a health plan or acute care ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with… more
