- Fallon Health (Worcester, MA)
- …requests for maternity, acute, subacute and discharge planning requests for all Utilization Management requests * Upload clinical to correct authorization, ... **Overview** **The UM Inpatient Service Coordinator is a...setting or physician's office; knowledge of managed care and/or utilization management strategies advisable * High level… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review/case management /clinical/or combination; 2 of the 4 ... **Job Title:** **Registered Nurse UM II** **Location: Columbia SC 29229** **Duration: 3+ month's Contract** **Job Description:** + Reviews and evaluates medical or… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …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
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The RN Utilization Management Nurse Coordinator is responsible for both concurrent and ... utilization requirements and 3rd party payor contracts. The UM department is responsible for LOS and Level of...to meet targets. + Participates in all aspects of utilization management . Assist with strategies, plans and… more
- Catholic Health Services (Melville, NY)
- … and Appeals Coordinator will perform activities to help facilitate utilization management and appeals functions to include coordination of specific process ... payment related activities. Position Responsibilities: | Prepares necessary documentation for utilization management and appeals processes, performs data … more
- Tenet Healthcare (Detroit, MI)
- …Mgt. Leaders relating to Case Management scope of services, including utilization management , transition management promoting appropriate length of stay, ... and safe and timely patient throughput. Will integrate national standards for utilization management supporting medical necessity and denials prevention. … more
- Catholic Health Initiatives (Lexington, KY)
- …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 ... effectively with multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate. +… more
- Dignity Health (Oxnard, 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
- Dignity Health (Glendale, 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
- Dignity Health (Carmichael, CA)
- …emphasis will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers and post ... Able to apply clinical guidelines to ensure progression of care + Understanding how utilization management and case management programs integrate + Knowledge… more
- Dignity Health (San Luis Obispo, 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
- Dignity Health (Long Beach, 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
- Dignity Health (Santa Cruz, 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
- Dignity Health (Phoenix, AZ)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... the Hospital. **Job Summary / Purpose** The RN Care Coordinator is responsible for overseeing the progression of care...+ Collaborate effectively with multiple stakeholders + 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 ... bonus eligibility, and more! **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and… more
- Catholic Health Initiatives (Chattanooga, TN)
- …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
- Bassett Healthcare (Cooperstown, NY)
- …principal liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate bed is ... care appropriate to each patient. Clinical and Technical Responsibilities: Provides case management services as appropriate throughout the life span and in various… more
- UCLA Health (Los Angeles, CA)
- …Medicare Advantage team, you will be responsible for assisting with the day-to-day management of the UM department and coordinators. This will involve ... team objectives and key performance indicators. You will hire and train non-clinical coordinator staff as well as manage and monitor their production and quality… more
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