- New York State Civil Service (New York, NY)
- …illness. Candidates from outside or within State Service can apply.As a Utilization Review Coordinator , your duties will include:* Reviewing clinical ... care facility regulated by Centers for Medicare and Medicaid Services Utilization Review Standards, or*...on the current Utilization Review Coordinator eligible list.ORCandidates within State Service can… more
- Scottish Rite for Children (Dallas, TX)
- …to giving children back their childhood! Job Posting Title: Case Manager and Utilization Review Coordinator Location: Dallas - Hospital Additional Posting ... and other areas as assigned + Serve on the Utilization Review Committee for the Scottish +...Develop and implement individualized care plans + Coordinate medical services and resources + Monitor and evaluate patient progress… more
- LifePoint Health (Louisburg, NC)
- …job field* **Organization:** **Maria Parham Franklin* **Title:** *Registered Nurse Utilization Review Coordinator * **Location:** *NC-Louisburg* **Requisition ... Registered Nurse (RN) Utilization Review Job Type: Full Time... plan, which ensures the appropriate use of hospital services , admissions, and extended stays. Key responsibilities include: -… more
- HCA Healthcare (Nashville, TN)
- …**Introduction** Do you want to join an organization that invests in you as a Utilization Review Services Coordinator ? At Parallonr, you come first. ... 3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off...make a difference. We are looking for a dedicated Utilization Review Services Coordinator… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Utilization Review /Quality Assurance Coordinator is responsible for all compliance related paperwork and ensures all compliance paperwork is ... or health care related setting required. Excellent communication and customer service skills required for interface with health care providers, payers, regulatory… 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 ... from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective...* Communicate with insurance providers to obtain authorization for services as needed. * Conduct utilization reviews… more
- Georgetown Behavioral Health Institute (Georgetown, TX)
- …is a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator . This position is responsible for working ... managed care systems for the authorization, concurrent and retrospective review of inpatient admissions and services . Key...access the full range of their benefits through the utilization review process. Requirements + Education: Master's… 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
- The County of Los Angeles (Los Angeles, CA)
- …REQUIREMENTS: OPTION I:One year of experience performing the duties of a Utilization Review Nurse* or Medical Service Coordinator , CCS.** -OR- OPTION II: ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...** In the County of Los Angeles, a Medical Service Coordinator , CCS (https://www.governmentjobs.com/careers/lacounty/classspecs/1065117) determines medical eligibility… more
- Comunilife (New York, NY)
- …and maintain Comunilife policies and procedures, quality assurance, utilization review and outreach activities. The Program Coordinator will collaborate with ... Program Coordinator -(OMH) LIP Washington Heights Job Details Job Location...None Job Shift Day Job Category Nonprofit - Social Services Description Comunilife Inc. is looking to fill a… more
- Select Medical (Los Angeles, CA)
- …caseload. + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator , etc., to assure ... care within the allotted timeframe; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation… more
- Select Medical (Los Angeles, CA)
- …caseload. + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator , etc., to assure ... care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of… more
- Select Medical (Columbus, OH)
- …of same. Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator , etc., to assure positive ... care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of… more
- Sharp HealthCare (San Diego, CA)
- …Care Coordinator , under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests for outpatient services ... . This position is responsible for conducting retrospective claims review for services to determine the medical...documents as appropriate for approval at the UM Care Coordinator level of review .Appropriately identify claims for… more
- WMCHealth (Valhalla, NY)
- Asst Utilization Coordinator - Appeals Company: Westchester Medical Center City/State: Valhalla, NY Category: Nursing/Nursing Management Department: Clinical ... Internal Applicant link Job Details: Internal Posting: 02/25/25 to 03/10/25 Assistant Utilization Coordinator Summary: Under general supervision, an incumbent of… more
- Humana (Frankfort, KY)
- …service or customer service , telephone experience + Experience with Utilization Review and/or Prior Authorization. preferably within a managed care ... our caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management for Humana's KY… more
- CenterWell (Topeka, KS)
- … or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care ... Coordinator - Phone Intake contributes to administration of utilization management. The UM Administration Coordinator performs varied activities… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...password may erase a candidate's original application record. ADA Coordinator Phone:### California Relay Services Phone: ###… more
- University of Utah Health (Salt Lake City, UT)
- …as a team member. **Qualifications** **Qualifications** **Required** + **One year** ** Utilization Review or Case Management experience.** **Licenses Required** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- Beth Israel Lahey Health (Burlington, MA)
- …making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse (RN) Case ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...holiday and beeper rotation as needed. 10) Supports all service line activities related to utilization and… more