- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-driven ** UM RN Appeals Coordinator .** This role collaborates with clinical review staff, ... to ensure consistent clinical evaluation and processing of medical necessity appeals . Accurate documentation and detailed recordkeeping of notifications to members… more
- Centene Corporation (Salem, OR)
- …Management at Superior HealthPlan or LPC, LCSW or Psy D. licensure within UM Behavioral Health Appeals team. **Specialty Therapy Requirement:** Master's degree ... on workplace flexibility. **Remote position.** **Pacific Standard Time is strongly preferred RN or LPN with utilization review, case management, and appeals … more
- Ellis Medicine (Schenectady, NY)
- …the chart to fax or send for insurance denials or quality improvement organization appeals . + Assists UM Coordinator with data entry of insurance ... and assist in utilization management activities under the direction of a registered nurse and/or social worker. Responsibilities include maintaining case files,… more
- Corewell Health (Dearborn, MI)
- …experience in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire ... review cases for medical necessity, uses InterQual and/or other UR/ UM Committee-approved medical necessity screening criteria, when appropriate. Works… more
- Corewell Health (Royal Oak, MI)
- …experience in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon ... review cases for medical necessity, uses InterQual and/or other UR/ UM Committee-approved medical necessity screening criteria, when appropriate. Works… more
- Cedars-Sinai (Beverly Hills, CA)
- …environment that fuels innovation. **A Little More About What You Will be Doing** The RN Care Coordinator is responsible for the case management of patient while ... care settings. In collaboration with the Inpatient Specialty Program (ISP) hospitalists, the RN Care Coordinator will assist patients from the time they are… more
- Saint Francis Health System (Tulsa, OK)
- …field. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or ... and their receipt of necessary services and appropriate discharge planning. UM Coordinators participate in treatment teams, communicating with providers the details… more
- San Antonio Behavioral Health (San Antonio, TX)
- …May consult with staff as needed. Essential Duties: + Collaborate and set standards with registered nurse ( RN ) case managers (CMs) and outcome managers to ... The Utilization Review Coordinator conducts utilization reviews to determine if patients...Identify and facilitate resolution of system process problems impeding UM functions. Identify and resolve delays and obstacles as… more
