- Clever Care Health Plan (Huntington Beach, CA)
- …organization. The coordinator will also work closely with Stars, Risk, UM /CM, Provider Relations, Member Services and other Clever teams to schedule appointments ... that celebrates diversity and innovation. Job Summary The HEDIS/Risk Outreach Coordinator is responsible for assisting with the deployment and implementation of… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role The UM Coordinator is responsible for coordinating all aspects of the prior authorization process, including member eligibility and benefit ... verification, gathering necessary clinical information from electronic medical record, and timely communication with members, providers and facility staff. Candidates should possess knowledge of third-party reimbursement regulations and medical terminology.… more
- Humana (Schaumburg, IL)
- …a part of our caring community and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization management. The ... UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations.… more
- University of Miami (Miami, FL)
- …time Recovery Coordinator 1 to work in Miami, FL. The Recovery Coordinator 1 ( UM LAORA) assists in the recovery, packaging, preservation and transportation ... of cadaveric organs to be used in surgical transplants. The incumbent also helps to ensures organ recovery activities are in accordance with all applicable regulatory standards and operating procedures. Also, this employee provides preservation support for… more
- Centers Plan for Healthy Living (Margate, FL)
- …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 Care program and facilitate authorization requests for eligible members. PRIMARY RESPONSIBILITIES: + Assists in the prior authorization of services and ongoing authorization requests + Assists in completing… more
- Fallon Health (Worcester, MA)
- …for incoming calls from the multiple ACD lines for the UM department addressing and/or referring customer (provider/member) calls/inquiries, provide direction ... Manage applicable queues in both the core system (QNXT UM and Call Tracking) and the case management application...focus toward excellent customer service. In addition, the Service Coordinator will attain the targets for a customer service… more
- Pomona Valley Hospital Medical Center (Pomona, CA)
- …The Licensed Vocational Nurse plays a vital role within the Case Management Department. The LVN within the Utilization Management team collaborates closely with Case ... Managers, support staff, insurance payers, and post-discharge vendors to ensure safe, timely, and efficient transitions of care. This coordination not only supports optimal patient outcomes but also helps ensure appropriate hospital reimbursement for services… more
- University of Miami (Coral Gables, FL)
- …and guests speakers to recruiting to promote the U Network to prospective recruits. Coordinator of the UM Women's Football Clinic + Organize efforts for a ... wives on their event participation. + Facilitate catering for event. + Coordinator for UM Footballs Wives Annual Football Trip + Plan and execute details for… more
- Dartmouth Health (New London, NH)
- …days of admission. Initiates discharge planning process. Maintains communication with UM coordinator regarding assessments, outcomes, and projected lengths of ... stay. Serves as a resource to the healthcare team, communicating with the physician, consultants, and all members of the healthcare team. Participates with the physician/multidisciplinary to review the plan and progress of care, to evaluate the effectiveness… more
- Ellis Medicine (Schenectady, NY)
- …or send for insurance denials or quality improvement organization appeals. + Assists UM Coordinator with data entry of insurance authorizations and denials. + ... Denial Management Activities + Assists Denial Management staff with clerical support; including facilitating MD to MD reviews. + Performs audit activities under the supervision of the Director of Case Management and Social Work Services. Ellis Medicine is… more
- University of Miami (Boca Raton, FL)
- …tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Clinical Research Coordinator 1 The University of Miami/UHealth ... an exciting opportunity for a Full Time Clinical Research Coordinator 1 to work at the UHealth Medical Campus....studies in Neurology. + Assist the PIs in developing UM protocols for submission to IRB, including but not… more
- University of Miami (Miami, FL)
- …tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Clinical Research Coordinator 1 The University of Miami/UHealth ... an exciting opportunity for a Full Time Clinical Research Coordinator 1 to work at the UHealth Medical Campus....operational failures occur. + Assist the PIs in developing UM protocols for submission to IRB, including but not… more
- University of Miami (Miami, FL)
- …Department of SCCC has an exciting opportunity for a Full Time Clinical Research Coordinator 1 for the UHealth medical campus in Miami, FL. CORE JOB SUMMARY The ... Clinical Research Coordinator 1 (A) serves as an entry-level clinical research...federal regulations, and sponsor requirements and as required per UM policy. + Participates in quarterly peer-review, quality control… more
- Saint Francis Health System (Tulsa, OK)
- …and their receipt of necessary services and appropriate discharge planning. UM Coordinators participate in treatment teams, communicating with providers the details ... to the Process Improvement/Quality Director, to appropriate clinicians and to the UM Manager. Reviews eligibility and benefits of patients, matching the level of… more
- University of Miami (Miami, FL)
- …. This position is fully onsite in Miami, FL. The Clinical Research Coordinator 2 serves as a mid-level clinical research professional that assists in the ... monitoring, and evaluating of specific clinical research studies. The Clinical Research Coordinator 2 will work within the Division of Digestive Health and Liver… more
- Veterans Affairs, Veterans Health Administration (Pensacola, FL)
- Summary The Strategic Analysis for Improvement and Learning (SAIL) Coordinator will serve as a facility content expert and provide oversight of the performance ... the facility and affiliated community-based outpatient clinics (CBOCs). The SAIL Coordinator must be knowledgeable about SAIL and other performance measures and… more
- Catholic Health Services (Melville, NY)
- …Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and appeals ... processes, performs data management and coordinates communication between members of the UM and Appeals teams to ensure timely follow through. + Reviews providers'… more
- CommonSpirit Health Mountain Region (West Jordan, UT)
- …help you flourish and leaders who care about your success. 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 the individual's health needs while promoting quality of care, cost… more
- University of Michigan (Ann Arbor, MI)
- Area Maintenance Coordinator Apply Now **How to Apply** A cover letter is required for consideration for this position and should be attached as the first page of ... to function reliably and efficiently. **Position Summary:** The Area Maintenance Coordinator (AMC) provides essential technical support to the operation of Student… more
- Dignity Health (Sacramento, CA)
- **Job Summary and Responsibilities** **Job 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 the individual's health needs while promoting quality of care,… more
