- BroadPath Healthcare Solutions (Tucson, AZ)
- …seeking a highly motivated and results-driven ** UM RN Appeals Coordinator .** This role collaborates with clinical review staff, medical directors/physician ... Friday; 8:00 AM -5:00 PM CST (Flexible) **Responsibilities** A. Performs necessary review to ensure compliance with HHSC and other regulatory entities + Collaborate:… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …serve through our Healthsource blog: https://healthsource.premera.com/ . The **Care Coordinator - Retrospective** performs prospective review (benefit advisory/ ... regulatory requirements, and ensures these requirements are accurately followed and Utilization Management ( UM ) decision determinations and timeliness standards… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …regulatory requirements, and ensures these requirements are accurately followed and Utilization Management ( UM ) decision determinations and timeliness standards ... we serve through our Healthsource blog: https://healthsource.premera.com/ . The **Care Coordinator - Inpatient RN** performs reviews of admissions and concurrent… more
- Integra Partners (Troy, MI)
- The Utilization Management ( UM ) Coordinator Supervisor oversees the day-to-day operations and performance of the UM Coordinator team. This position ... teamwork across the department. Salary: $65,000/annual JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES UM Coordinator Supervisor responsibilities include but are… more
- Humana (Indianapolis, IN)
- …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 (Phoenix, AZ)
- …a part of our caring community and help us put health first** The UM ( Utilization Management) Administration Coordinator 2 contributes to administration of ... utilizing electronic medical record and documentation programs + Experience with Utilization Review and/or Prior Authorization, preferably within a managed… more
- Pomona Valley Hospital Medical Center (Pomona, CA)
- …education necessary to meet licensure requirements. One year experience in Utilization Review or Case Management discharge planning, current knowledge/use ... vital role within the Case Management Department. The LVN within the Utilization Management team collaborates closely with Case Managers, support staff, insurance… more
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the...appeals. JOB RESPONSIBILITIES + Monitor incoming faxes + Enter UM authorizations review requests in UM ... 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)
- …caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management. The UM ... new systems (proficient to advanced) **Preferred Qualifications** + Experience with Utilization Review and/or Prior Authorization, preferably within a managed… more
- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate ... timely follow through. + Reviews providers' requests for services and coordinates utilization /appeals management review . + Assist Utilization and Appeals… more
- Saint Francis Health System (Tulsa, OK)
- …participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of ... administrative and clinical support to the hospital and treatment team throughout the review of patients, their placement in various levels of care and their receipt… more
- Cedars-Sinai (Beverly Hills, CA)
- …for medical necessity, appropriateness of care and level of care. Use evidence based review guidelines to conduct utilization review as is appropriate to ... innovation. **A Little More About What You Will be Doing** The RN Care Coordinator is responsible for the case management of patient while hospitalized and upon… 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 ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… more
- Dignity Health (Bakersfield, 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 ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… 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 (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 ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… 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 ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients… 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
- Corewell Health (Dearborn, MI)
- …patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). + ... years of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + Registered… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …to enhance the patient experience. Performs other duties as assigned, including utilization review as necessary. **Job Requirements** **Required Education and ... **Job Summary and Responsibilities** Job Summary / Purpose The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for… more
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