- Humana (Oklahoma City, OK)
- …our caring community and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization management. The UM ... member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care… more
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the clinical...not limited to: + Monitor incoming faxes + Enter UM authorizations review requests in UM ... Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorizations and appeals. Rate of Pay:...+ At least 1 year of experience as a UM Coordinator or similar administrative role within… more
- Trinity Health (Columbus, OH)
- …technology, financial analysis, audit, provider relations and more. **Position Purpose** RN Utilization Review MCHP is responsible for the coordination of the ... as appropriate. Assist in the development of the Plan's UM Program and the review of the...Sr. Director of Medical Management. + Coordinates with the utilization review , case management, discharge planning staff… 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 Full Time Days -...an authorization process Closes open cases on the incomplete UM Census Completes the Medicare Certification Checklist on applicable… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- …(VAGLAHS) is seeking to hire experienced Registered Nurses to work in our Utilization Management ( UM ) Program. Incumbents are expected to perform assessing, ... following: Demonstrates ability to perform a wide range of Utilization Management/Quality Management/Performance Improvement ( UM /QM/PI) activities that impact… more
- Actalent (Santa Barbara, CA)
- …Plan Nurse Coordinator Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a contract basis! Opportunity ... REQUIREMENTS: + CA RN license + Medi-Cal Experience + Utilization Management WHAT'S IN IT FOR YOU: + Remote...a leading healthcare organization Description: The Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned… more
- University of Miami (Miami, FL)
- …or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Life ... Miami/UHealth is currently seeking a full time Organ Allocation Coordinator 1. The Organ Allocation Coordinator 1...responsible for all activities related to the allocation and utilization of organs from donors. Including, organ allocation for… 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 ... **Responsibilities** The Care Coordinator RN is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… 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 ... **Responsibilities** 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
- Virginia Mason Franciscan Health (Tacoma, WA)
- …to their practice. 13. Performs other duties as assigned, including utilization review as necessary. **Qualifications** **Education and Experience** Required ... **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge planning for identified… more
- Dignity Health (Glendale, 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 ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… 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 ... bonus not to exceed 10% of salary for this position. The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for… more
- Virginia Mason Franciscan Health (Gig Harbor, WA)
- …to their practice. 13. Performs other duties as assigned, including utilization review as necessary. **Qualifications** **Education and Experience** Required ... **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge planning for identified… 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 ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… more
- Dignity Health (Phoenix, AZ)
- …confidentiality while striving to achieve high levels of patient satisfaction. The Care Coordinator consistently conducts the utilization review process and ... **Responsibilities** The Care Coordinator is responsible for assessing planning facilitating and...Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification Training: + Knowledge of managed care and… more
- Corewell Health (Royal Oak, MI)
- …patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2. ... years of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + Registered… more
- Dignity Health (Sacramento, CA)
- …while striving to achieve high levels of patient satisfaction. The RN Care Coordinator consistently conducts the utilization review process and the ... **Responsibilities** **Position Summary:** The RN Care Coordinator is responsible for assessing, planning, facilitating and...Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred + At least five (5) years… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors ... status of approvals from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use of… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Hussman ... Institute has an exciting opportunity for a full time Clinical Research Coordinator 2 position. The incumbent serves as a mid-level clinical research professional… more
- Covenant Health Inc. (Knoxville, TN)
- …patient liability is correctly managed. + Keeps abreast of current changes affecting Utilization Review as applicable. + Adjusts patient type changes and charges ... Overview Physician Advisor Operations Coordinator , Revenue Integrity and Utilization PRN/OCC,...management processes and coordinates communication between members of the UM team to ensure timely follow through. Maintains electronic… more
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