- Actalent (Redlands, CA)
- …protocols. This role involves effective communication and interaction with utilization review nurses and health plans regarding UM and referral authorization ... Job Title: UM CoordinatorJob Description The Utilization Management ( UM ) Coordinator ...specialty services. + Communicate effectively with utilization review nurses and health plans on UM … more
- Humana (Columbia, SC)
- …procedures ensuring best and most appropriate treatment, care or services for members. Telephonic UM Coordinator / UM Administration Coordinator 2 + ... and help us put health first** The Telephonic - UM Administration Coordinator / UM Administration...and/or ICD-10 codes. + Member service + Experience with Utilization Review and/or Prior Authorization, preferably within… more
- Humana (Little Rock, AR)
- …make an impact** **Required Qualifications** + 1 or more years of experience with Utilization Review and/or Prior Authorization + 1 or more years of Healthcare ... of our caring community and help us put health first** The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring… more
- CenterWell (Tallahassee, FL)
- …our caring community and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization management. The UM ... member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care… more
- Humana (Schaumburg, IL)
- …and/or experience with medical terminology and/or ICD-10 codes. + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care ... put health first** Humana Gold Plus Integrated is seeking a UM Administration Coordinator who typically focuses on interpretation of department policy and… more
- Tenet Healthcare (Detroit, MI)
- …of care and appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. (5% daily, ... RN Utilization Review Full Time Days -...an authorization process Closes open cases on the incomplete UM Census Completes the Medicare Certification Checklist on applicable… more
- Cedars-Sinai (Beverly Hills, CA)
- …Will be Doing** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all team ... or Management. + Processes Extensions and Denial Letters, when needed. + Prepares Utilization Review Reports as necessary. + Assists the Case/Care Managers in… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …located within hospital + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. Preferred + Bachelor's Degree in Nursing ... **Responsibilities** The Care Coordinator RN is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… more
- Catholic Health Initiatives (Schuyler, NE)
- …if located within hospital + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ... **Responsibilities** **Job Summary / Purpose** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …to their practice. 13. Performs other duties as assigned, including utilization review as necessary. **Qualifications** **Education and Experience** Required ... **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge planning for identified… more
- Dignity Health (Glendale, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of...will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers and post… more
- Virginia Mason Franciscan Health (Gig Harbor, WA)
- …to their practice. 13. Performs other duties as assigned, including utilization review as necessary. **Qualifications** **Education and Experience** Required ... **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge planning for identified… more
- Dignity Health (Los Angeles, CA)
- …90 days of hire. + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... bonus not to exceed 10% of salary for this position. The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for… more
- Dignity Health (Phoenix, AZ)
- …confidentiality while striving to achieve high levels of patient satisfaction. The Care Coordinator consistently conducts the utilization review process and ... **Responsibilities** The Care Coordinator is responsible for assessing planning facilitating and...Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification Training: + Knowledge of managed care and… more
- Corewell Health (Royal Oak, MI)
- …patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2. ... years of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + Registered… 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
- Dignity Health (San Bernardino, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Responsibilities** As an RN Care Coordinator at St. Bernardine Medical Center, you will...+ Monitor patient progression of care, ensuring appropriate resource utilization and timely discharge. + Serve as a liaison… more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Hussman ... Institute has an exciting opportunity for a full time Clinical Research Coordinator 2 position. The incumbent serves as a mid-level clinical research professional… more