- Actalent (Redlands, CA)
- Job Title: UM CoordinatorJob Description The Utilization Management ( UM ) Coordinator is responsible for executing all aspects of the referral ... process. The UM Coordinator collaborates with clinical team members...Experience with Independent Physician Associations (IPAs), Managed Care, and Utilization Management . + High school diploma or… more
- CenterWell (Tallahassee, FL)
- …first** The UM Administration Coordinator 2 contributes to administration of utilization management . The UM Administration Coordinator 2 performs ... support assignments. Performs computations. Typically works on semi-routine assignments. The UM Administration Coordinator 2 provides non-clinical support for… more
- Humana (Schaumburg, IL)
- …has some latitude over prioritization and timing. The UM Administration Coordinator contributes to the administration of care management and provides ... help us put health first** Humana Gold Plus Integrated is seeking a UM Administration Coordinator who typically focuses on interpretation of department policy… more
- Centers Plan for Healthy Living (Margate, FL)
- …with the guidance and 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 +… more
- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY: Under the supervision of the Utilization Management ( UM ) Operations Supervisor, the UM Coordinator I's primary job function is to ... the provider call center lines), and appropriately processing required UM notifications (letters, faxes, etc.). MINIMUM QUALIFICATIONS: HS Diploma,GED,or Equivalent… more
- Cedars-Sinai (Beverly Hills, CA)
- …**A Little More About What You Will be Doing** The Case Management Coordinator provides support to the utilization review process. The coordinator works ... collaboratively with all team members of Utilization Management , Patient and Provider Services, Claims Department and other...preferred. **Req ID** : 10884 **Working Title** : Case Management Coordinator (Hybrid) - MNS Ambulatory Care… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention ... potentially avoidable days Other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical and financial requirements and… more
- Catholic Health Initiatives (Schuyler, NE)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. +… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and ... **Responsibilities** The Care Coordinator RN is responsible for overseeing the progression...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Henry Ford Health System (Troy, MI)
- RN REFERRAL MANAGEMENT COORDINATOR (VIRTUAL) - PRIOR AUTHORIZATIONS - 40 HOURS - DAY SHIFT Full Time Benefit Eligible Schedule: Monday through Friday, 8:00AM to ... the time of the denial and distributes to the Utilization Management Services staff for processing. +...for further investigation and validation. Tracks physician non-compliance with UM Policies & Procedures and report to QM Department… more
- Dignity Health (Glendale, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Dignity Health (Long Beach, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Dignity Health (Long Beach, CA)
- …emphasis will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers and post ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Dignity Health (Los Angeles, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... 10% of salary for this position. The RN Care Coordinator is responsible for overseeing the progression of care...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge planning for identified… more
- Virginia Mason Franciscan Health (Gig Harbor, WA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge planning for identified… more
- Dignity Health (Phoenix, AZ)
- …problem-solving skills. + Collaborate effectively with multiple stakeholders + Understand how utilization management and case management programs integrate. ... to achieve high levels of patient satisfaction. The Care Coordinator consistently conducts the utilization review process...hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year… more
- Dignity Health (Merced, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... effectively with multiple stakeholders + Professional communication skills + Understand how utilization management and case management programs integrate. +… more
- Corewell Health (Royal Oak, MI)
- …of care and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning, and appropriate ... Responsible for managing a case load of patients that includes facilitating utilization management , and/or care coordination during the patient's stay, planning… more
- CommonSpirit Health Mountain Region (Lakewood, CO)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... leaders who care about your success. The RN Care Coordinator is responsible for overseeing the progression of care...hospital clinical experience or a Master's degree in Case Management or Nursing field in lieu of acute experience.… more