- Centers Plan for Healthy Living (Staten Island, NY)
- …guidance and plans they need for healthy living. JOB SUMMARY: The Utilization Management Care Coordinator works within a multidisciplinary care team to ... + Strong multi-tasking abilities Preferred: + Experience working within a managed care environment Specific Technical Skills Preferred: Computer proficiency… more
- Integra Partners (Troy, MI)
- …Maintaining expected timelines EXPERIENCE: + 1 year as a UM Coordinator in a managed care payer environment preferred + Knowledge of ICD-10, HCPCS codes ... The UM Coordinator assists and supports the...Members access to top local Providers and culturally competent care . By focusing on transparency, accountability, and adaptability, we… 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 ... sign-on bonus not to exceed 10% of salary for this position. The RN Care Coordinator is responsible for overseeing the progression of care and discharge… more
- Dignity Health (Phoenix, AZ)
- …Accredited Case Manager (ACM-RN), or UM Certification Training: + Knowledge of managed care and payer environment preferred. + Must have critical thinking ... furthering the mission of the Hospital. **Job Summary / Purpose** The RN Care Coordinator is responsible for overseeing the progression of care and discharge… more
- Dignity Health (Merced, CA)
- **Job Summary and Responsibilities** **Position Summary** 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 (Long Beach, CA)
- …Case Manager (ACM-RN) or UM Certification preferred + Knowledge of managed care and payer environment preferred. **Where You'll Work** CommonSpirit Health ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified… more
- Dignity Health (Bakersfield, CA)
- …Case Manager (ACM-RN) or UM Certification preferred + Knowledge of managed care and payer environment preferred **Where You'll Work** Bakersfield Memorial ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified… more
- Dignity Health (Long Beach, CA)
- …Case Manager (ACM-RN), or UM Certification preferred + Knowledge of managed care and payer environment preferred. **Where You'll Work** CommonSpirit Health ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified… more
- Dignity Health (Glendale, CA)
- …Accredited Case Manager (ACM-RN), or UM Certification preferred + Knowledge of managed care and payer environment preferred. **Where You'll Work** Founded in ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified… 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
- Fallon Health (Worcester, MA)
- …a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon ... Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical… more
- San Antonio Behavioral Health (San Antonio, TX)
- …and Microsoft Outlook, Word and Excel. + Has knowledge of governmental and managed care payer requirements. + Demonstrates understanding of the various ... The Utilization Review Coordinator conducts utilization reviews to determine if patients...conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts… more
- Dignity Health (Gilbert, AZ)
- …Accredited Case Manager (ACM-RN), or UM Certification Training: + Knowledge of managed care and payer environment + Must have critical thinking and ... Team are dedicated to furthering the mission of the Hospital. The RN Care Coordinator is responsible for overseeing the progression of care and discharge… more
- University of Southern California (Alhambra, CA)
- …MCG reviews are completed within 24 hours of admission; Observation patients are effectively care managed on a daily basis; and Facilitate throughput and timely ... data from multiple sources, as supported by the ambulatory care coordinator . 4. Analyze and interpret data...Hospital admissions, or Re-admissions. 4. Maintains awareness of current managed care contract requirements. 5. Coordinate the… more
- Katmai (Fort Carson, CO)
- …DUTIES & RESPONSIBILITIES** + Act as coordinator /liaison with providers, staff and Managed Care Support Contractor (MCSC) to ensure that actual health ... Provide a comprehensive utilization review (UR) and utilization management ( UM ) program for all TRICARE eligible beneficiaries within the...care received is appropriate to meet TRICARE beneficiaries' healthcare… more
- Tenet Healthcare (Detroit, MI)
- …UR Committee, Denial and Revenue Cycle Collaborate with Patient Access, Case Management, Managed Care and Business Office to improve concurrent review process to ... pet insurance, legal insurance, accident and critical illness insurance, long term care , elder & childcare, auto & home insurance. Note: Eligibility for benefits… more