- Luminis Health (Lanham, MD)
- …operational throughout process in collaboration wth other unit leaders, Administrative Coordinator , Care Management , other nursing unit and support services ... to the unit at education/staff development functions as well as designated management functions to promote high quality, cost effective health care. This position… more
- Luminis Health (Lanham, MD)
- …operational throughout process in collaboration wth other unit leaders, Administrative Coordinator , Care Management , other nursing unit and support services ... to the unit at education/staff development functions as well as designated management functions to promote high quality, cost effective health care. This position… more
- Campbell County Health (Gillette, WY)
- …the Admission and Discharge Coordinator focuses on integrating care management , social services, discharge planning, utilization review and post-hospital ... functions of care coordination, facilitation of referrals, education, discharge planning, utilization management , and advocacy. ESSENTIAL FUNCTIONS * Completes… more
- HCA HealthONE Rose (Denver, CO)
- …Nurses! Introduction Do you have the career opportunities as a(an) Clinical Nurse Coordinator Inpatient Surgery you want with your current employer? We have an ... group of colleagues. Do you want to work as a(an) Clinical Nurse Coordinator Inpatient Surgery where your passion for creating positive patient interactions is… more
- NHS Management (Prattville, AL)
- …services at the highest practicable level for each resident. Provides case management services for certain high-risk Medicare Part A residents to ensure services ... to facilities on Medicare eligibility, certification, coverage questions, documentation and utilization and provides training to facility staff as indicated. Reviews… more
- Houston Behavioral Healthcare Hospital (Houston, TX)
- …together. Houston Behavioral Healthcare Hospital (HBHH) currently has an opening for Part-time Utilization Management Coordinator . The Utilization ... Coordinator will report to the Director of Utilization Review and will be responsible to provide quality...Review and will be responsible to provide quality case management services to all patients and their families, to… more
- South Middlesex Opportunity Council (Framingham, MA)
- …casual Working Conditions: As part of the responsibilities of this position, the Utilization Management Coordinator will have direct or incidental contact ... children and families. This position will coordinate billing and monitor utilization review for the Clinic and Residential Recovery Programs. Candidates must… more
- Penn State Health (Hershey, PA)
- …direction of a Utilization Management Nurse or Specialist, the Utilization Management Coordinator supports the UM process by obtaining ... orders that prohibit or outlaw discrimination._ **Union:** Non Bargained **Position** UM Coordinator - Utilization Management **Location** US:PA: Hershey |… more
- Hackensack Meridian Health (Edison, NJ)
- …and serve as a leader of positive change. The **Care Management , Care Coordinator , Utilization Management ** is a member of the healthcare team and ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator , Utilization Management plans effectively in order to manage length… more
- Integra Partners (Troy, MI)
- …Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES ... The UM Coordinator assists and supports the clinical team (UM...expectations and functions of the UM team + Time Management What will you achieve in the first 12… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …to transform healthcare and serve as a leader of positive change. The ** Utilization Management Coordinator ** utilizes clinical knowledge and understanding of ... appropriate alternative level of care setting for continued treatment. Employs the utilization management process to assist in setting priorities, planning,… more
- Saint Francis Health System (Tulsa, OK)
- …in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal ... Reviews eligibility and benefits of patients, matching the level of care utilization . Assures compliance with Managed Care Behavioral Health standards in the area… more
- Evolent (Annapolis, MD)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The ** Coordinator , Intake Utilization Management ** at Evolent will serve as a ... regulatory requirements, and client contractual agreements. **Collaboration Opportunities** : The Coordinator , Intake Utilization Management reports directly… more
- Veterans Affairs, Veterans Health Administration (El Paso, TX)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Responsibilities… more
- Sharp HealthCare (San Diego, CA)
- …as required, to discuss high risk patients requiring case management follow up.Attends clinical in-services or required operational/clinical training sessions. ... by phone.Tracks and documents key performance measures related to inpatient management per requirements.Reviews patient medical record including, but not limited, to… 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
- St. Luke's University Health Network (Allentown, PA)
- …utilization management of psychiatric cases in the absence of the utilization management coordinator . PHYSICAL AND SENSORY REQUIREMENTS: Able to ... and the Manager regarding variances, aspects of patient care management . + Facilitates insurance authorization, pre-certification, and concurrent reviews for… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …BHPS provides Utilization Review services to its clients. The UM Denials Coordinator supports the Utilization Management function by reviewing denied and ... partially denied authorizations and preparing denial correspondence within the Utilization Management system. This role is responsible for drafting, editing, and… more
- Behavioral Center of Michigan (Warren, MI)
- …all state mandated regulations. Maintains compliancy with regulation changes affecting utilization management . Reviews patient recrods and evaluates patient ... Under general supervision, the Utilization Review Coordinator provides professional assessment,...and advises physicians and other departments of regulations affecting utilization management . Consults with Social Services Department… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and ... preferred **Knowledge, Skills and Abilities** + Strong knowledge of utilization management principles, payer requirements, and healthcare regulations.… more
