- 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, medical ... directors/physician reviewers, network physicians, and network facilities to ensure consistent clinical evaluation and processing of medical necessity appeals. Accurate documentation and detailed recordkeeping of notifications to members and network providers… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …through our Healthsource blog: https://healthsource.premera.com/ . The **Care Coordinator - Retrospective** performs prospective review (benefit advisory/ prior ... and ensures these requirements are accurately followed and Utilization Management ( UM ) decision determinations and timeliness standards are within compliance. +… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …we serve through our Healthsource blog: https://healthsource.premera.com/ . The **Care Coordinator - Inpatient RN** performs reviews of admissions and concurrent ... and ensures these requirements are accurately followed and Utilization Management ( UM ) decision determinations and timeliness standards are within compliance +… more
- Integra Partners (Troy, MI)
- …) Coordinator Supervisor oversees the day-to-day operations and performance of the UM Coordinator team. This position ensures that all intake, triage, and ... teamwork across the department. Salary: $65,000/annual JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES UM Coordinator Supervisor responsibilities include but are… more
- Humana (Indianapolis, IN)
- …a part of our caring community and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization management. The ... UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations.… more
- Humana (Phoenix, AZ)
- …part of our caring community and help us put health first** The UM (Utilization Management) Administration Coordinator 2 contributes to administration of ... our commitments to serving our customers with excellence. As a Utilization Management Coordinator 2, you will be an integral part of a fast-paced, metric-driven team… more
- Centers Plan for Healthy Living (Margate, FL)
- …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 + Assists in completing… more
- Fallon Health (Worcester, MA)
- …for incoming calls from the multiple ACD lines for the UM department addressing and/or referring customer (provider/member) calls/inquiries, provide direction ... Manage applicable queues in both the core system (QNXT UM and Call Tracking) and the case management application...focus toward excellent customer service. In addition, the Service Coordinator will attain the targets for a customer service… more
- Pomona Valley Hospital Medical Center (Pomona, CA)
- …The Licensed Vocational Nurse plays a vital role within the Case Management Department. The LVN within the Utilization Management team collaborates closely with Case ... Managers, support staff, insurance payers, and post-discharge vendors to ensure safe, timely, and efficient transitions of care. This coordination not only supports optimal patient outcomes but also helps ensure appropriate hospital reimbursement for services… more
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the clinical team ( UM Nurses/Medical Director) with administrative and non-clinical tasks related to processing ... HCPC codes + Maintaining expected timelines EXPERIENCE: + 1 year as a UM Coordinator in a managed care payer environment preferred + Knowledge of ICD-10, HCPCS… more
- Humana (Concord, NH)
- …a part of our caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management. The ... UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations.… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Division of Hospital Medicine & Utilization Management ( UM ) Project Coordinator plays a key role in supporting various departments within UM ... and Division of Hospital Medicine by ensuring smooth operations, facilitating communication, and enhancing the overall cross-functional collaboration between academic, clinical, quality, and finance departments. This role ensures that projects are started,… more
- University of Miami (Coral Gables, FL)
- …and guests speakers to recruiting to promote the U Network to prospective recruits. Coordinator of the UM Women's Football Clinic + Organize efforts for a ... wives on their event participation. + Facilitate catering for event. + Coordinator for UM Footballs Wives Annual Football Trip + Plan and execute details for… more
- University of Michigan (Ann Arbor, MI)
- …+ As UM Health expands, the Injury Prevention and Outreach Coordinator will partner and coordinate staff at affiliated hospitals to support and coordinate ... Injury Prevention and Outreach Coordinator Apply Now **Job Summary** The Injury Prevention...prevention/community outreach based and promoted at University of Michigan ( UM ) Health and affiliated institutions (eg Stop the Bleed).… more
- University of Miami (Miami, FL)
- …Department of SCCC has an exciting opportunity for a Full Time Clinical Research Coordinator 2 to work at the UHealth campus in Miami, Fl. CORE JOB SUMMARY ... The Clinical Research Coordinator 2 serves as a mid-level clinical research professional...Maintains study binders and filings according to protocol requirements, UM and department policy. 5. Distributes study drug materials… more
- University of Michigan (Ann Arbor, MI)
- Administrative Coordinator /Project Coordinator Apply Now **How to Apply** A cover letter and resume are required; the cover letter should be Page 1 of your ... African Studies (DAAS) is seeking an enthusiastic, personable, task-oriented Administrative/Project Coordinator to join our team. We seek a dynamic individual with… more
- University of Miami (Miami, FL)
- …Department of SCCC has an exciting opportunity for a Full Time Clinical Research Coordinator 1 to work at the UHealth campus in Miami, Fl. CORE JOB SUMMARY ... The Clinical Research Coordinator 1 serves as an entry level clinical research...JHS CTO Office protocol specific forms as required per UM and/or JHS policies. Assist in the completion of… more
- University of Miami (Boca Raton, FL)
- …tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Clinical Research Coordinator 1 The University of Miami/UHealth ... an exciting opportunity for a Full Time Clinical Research Coordinator 1 to work at the UHealth Medical Campus....studies in Neurology. + Assist the PIs in developing UM protocols for submission to IRB, including but not… more
- University of Miami (Miami, FL)
- …Health has an exciting opportunity for a full time International Patient Coordinator in Miami. The incumbent organizes and manages all necessary arrangements for ... pricing and bundled packages, obtains CPT codes and diagnosis information from UM physicians, obtains letters of agreement and payments from international payers,… more
- Saint Francis Health System (Tulsa, OK)
- …and their receipt of necessary services and appropriate discharge planning. UM Coordinators participate in treatment teams, communicating with providers the details ... to the Process Improvement/Quality Director, to appropriate clinicians and to the UM Manager. Reviews eligibility and benefits of patients, matching the level of… more
Related Job Searches:
Bilingual Telephonic UM Coordinator,
Coordinator,
UM Coordinator Inpatient Case,
UM Coordinator Utilization Review