- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Compliance ( UM ) Coordinator 2 conducts and summarizes compliance audits. The Compliance ( UM ... on a rotating schedule. (about 2 holidays per year) The Compliance ( UM ) Coordinator 2 generates notice of adverse benefit determination and approval letters for… more
- Universal Health Services (Oakland Park, FL)
- … - RN Denials & Appeals (Experience a must) The main duties of the UM Coordinator - RN are: to coordinate and monitor appropriate utilization and documentation ... inpatient and outpatient programs and coordinate authorization with third-party payors. UM Coordinators also review cases for appropriateness of admission, continued… more
- Centers Plan for Healthy Living (Margate, FL)
- UM Coordinator 5297 W Copans Rd, Margate, FL 33063, USA Req #1209 Monday, April 1, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... 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… more
- Humana (Columbus, OH)
- …Coordinator 2 who contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately ... Are you caring, Curious and Committed? If so, apply today! The UM Administration Coordinator 2 + Provides non-clinical support for the policies and procedures… 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
- 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
- Apex Health Solutions (Houston, TX)
- …Coordinator , Utilization Management Department: Medical Management Supervisor: UM Supervisor/Manager, Medical Management The Utilization Management Coordinator ... for the utilization review (UR) of healthcare services. The UM Specialist works within prescribed guidelines and procedures; uses...input service requests for a review determination by the UM Reviewer, Medical Management Manager ( UM Manager)… more
- Universal Health Services (Orlando, FL)
- …Position Summary The Utilization Review Coordinator performs admission and concurrent review ... of patients. Assures optimum quality of patient care in the most cost-effective manner. Works closely with the Physicians and the Social Services department to ensure quality of documentation of patient care. Completes Medicare B-Tag audits. Job… more
- Healthfirst (NY)
- The Support Coordinator is responsible for assisting the care/case managers with non-clinical activities such as creating cases and events; providing telephonic ... Individual Health Care Plans on behalf of the care/case managers. The Support Coordinator is assigned to a specific clinical team (such as Care Management,… more
- Universal Health Services (Doylestown, PA)
- …response to denial of initial or continued stay certification. + Internally, the UM Coordinator will interface with hospital management, staff, and patients. + ... Externally, the UM Coordinator will interface with licensing and accrediting agencies, managed care companies, family members, and healthcare treatment agencies.… more
- Universal Health Services (Philadelphia, PA)
- …psychiatric and chemical dependency treatment. We are currently seeking a Utilization Management ( UM ) Coordinator to join our team. Utilization Management ( UM ... Position Fairmount Behavioral Health System is seeking a Utilization Management ( UM ) Coordinator to reviews patient medical records to determine severity… more
- Humana (Oklahoma City, OK)
- …The Utilization Management ( UM ) Coordinator contributes to administration of UM . The UM Coordinator performs varied activities and moderately complex ... administrative, operational, and Enrollee support assignments. The individual in this role performs computations and typically works on semi-routine assignments.RESPONSIBILITIES: * Provides nonclinical support for the policies and procedures, ensuring best and… more
- Universal Health Services (Madera, CA)
- …We are currently seeking a forward thinking and compassionate UTILIZATION MANAGEMENT( UM ) COORDINATOR . Facilitates a continuum of service while promoting ... positive outcome and optimal reimbursement, through coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting. QUALIFICATIONS Education: Bachelor's degree in Nursing, Psychology or Social Work (MSW required)… more
- Universal Health Services (Bradenton, FL)
- …patient care. This position is responsible for the hiring and development of the UM Coordinator and the Admission Coordinator positions. This position also ... services in rotation for administration on call. Benefits + Challenging and rewarding work environment + Competitive Compensation and Generous Paid Time Off + Excellent Medical, Dental, Vision and Prescription Drug Plans + 401(k) with company match and… more
- Tri-County Mental Health Services (Kansas City, MO)
- …licensing, accreditation, and agency credentialing/re-credentialing process. * Provides back-up for UM Coordinator for therapy referrals and high-risk review. * ... Provides back-up for Compliance Specialist for practitioner credentialing and privileging. * Assists with outcome data collection and reporting as needed. * Provides other trainings as directed by the manager. **MINIMUM QUALIFICATIONS (KNOWLEDGE, SKILLS, AND… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …reimbursement and denial process. Works with infusion center to prevent denials. Assists UM Coordinator with denials and appeals. Close out each tracked denial ... (overturned or recouped). Overall works to increase revenue capture related to infusion center. Facility resource for denials/appeal process and regulatory compliance as it relates to the infusion center. Must manage competing priorities, multi-task with… more
- Bassett Healthcare (Cooperstown, NY)
- …Best-In-State Employer 2022! What you'll do The Unit Clinical Care Coordinator Registered Nurse acts a principle liaison between emergency services, surgical ... status and level of care matches order. Collaborates with UM Nurse to assure that all payor and status...on discharge needs/barriers for all patients; initiates intervention by UM Nurse as needed. Identifies need for patient to… more
- Bassett Healthcare (Cooperstown, NY)
- …care (ICU, Med/Surg, etc.). Works collaboratively with unit staff and support team ( UM Nurse, Complex C3, etc.) to progress each patient's care towards discharge. ... status and level of care matches order. Collaborates with UM Nurse to assure that all payor and status...on discharge needs/barriers for all patients; initiates intervention by UM Nurse as needed. Identifies need for patient to… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Referrals Coordinator 2 processes referrals from Military Treatment Facilities (MTFs) and civilian providers. ... The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer...Military referral processes, MOUs with MTFs, and referral and UM policies. + Answers questions or contacts MTFs and/or… more
- University of Miami (Miami, FL)
- …. The Department of Otolaryngology is currently seeking a full time Clinical Research Coordinator 1 to work in Miami, FL. The Clinical Research Coordinator ... and update and maintenance of documentation. Moreover, the Clinical Research Coordinator develops, verifies, and implements procedures to accomplish research goals.… more