- University Health (San Antonio, TX)
- …years recent, full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance experience is ... POSITION SUMMARY/RESPONSIBILITIES Care Coordinator will be instrumental in assisting the department...clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF… 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 ... preferred. Must complete a Clinical Documentation Improvement Course within specified time of hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National… more
- Crown Cork & Seal USA, Inc. Careers (Owatonna, MN)
- …Safety Analyses (JSAs), and safety regulations. Strong understanding of inventory management and parts utilization processes. Direct experience in ... Position Overview: The Back End Coordinator is responsible for coordinating team members, maintenance,...they are being consistently followed. Track and monitor parts utilization and inventory, and place orders as necessary to… 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 ... operations by performing any non-clinical tasks. This includes, but is not limited to, initial authorization processing, (data entry, eligibility verification, benefits verification, and requesting required supporting documents from submitting provider… 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...types of case reviews for quality and appropriate medical management , cost containment, peer review and rehabilitation; + Implement… 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
- Hackensack Meridian Health (Edison, NJ)
- …and serve as a leader of positive change. The **Care Management , Care Coordinator , Utilization Management ** is a member of the healthcare team and ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator , Utilization Management plans effectively in order to manage length… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and ... preferred **Knowledge, Skills and Abilities** + Strong knowledge of utilization management principles, payer requirements, and healthcare regulations.… 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 ... for vented children, ie generators, housing, rentals) * Collaborate with care management and utilization management teams in monitoring behavioral… 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
- 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
- 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
- Integra Partners (Troy, MI)
- …Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES ... The UM Coordinator assists and supports the clinical team (UM...expectations and functions of the UM team + Time Management What will you achieve in the first 12… more
- Henry Ford Health System (Troy, MI)
- …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...Additional Information + Organization: Community Care Services + Department: Pharmacy- Utilization Mgmt + Shift: Day Job + Union Code:… more
- Sharp HealthCare (San Diego, CA)
- …as required, to discuss high risk patients requiring case management follow up.Attends clinical in-services or required operational/clinical training sessions. ... by phone.Tracks and documents key performance measures related to inpatient management per requirements.Reviews patient medical record including, but not limited, to… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS. ... and the TRICARE Operations Manual (TOM) access to care standards for appropriate utilization of services. Perform utilization management /review for medical… more
- LifeCenter Northwest (Bellevue, WA)
- … (OUM) provides strategic leadership and operational oversight for the Organ Utilization Coordinator Team (OUCT), directing key aspects of abdominal organ ... Responsibilities + Lead and engage daily with the Organ Utilization Coordinator (OUC) team in donor case...or operational needs. + Collaborate with the Director, Organ Utilization , to manage departmental budgets and identify cost- management… more
- The County of Los Angeles (Los Angeles, CA)
- …SELECTION REQUIREMENTS: OPTION I:One year of experience performing the duties of a Utilization Review Nurse* or Medical Service Coordinator , CCS.** -OR- OPTION ... UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply... Review Nurse is an RN that has Case Management experience whose primary charge is to ensure that… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention ... potentially avoidable days Other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical and financial requirements and… 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 ... collaborative and supportive liaison and educator to providers and staff around utilization management principles. This professional role will be responsible… more
