- 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
- 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
- Humana (Oklahoma City, OK)
- …first** The UM Administration Coordinator 2 contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied ... Performs computations. Typically works on semi-routine assignments. The UM Administration Coordinator 2 + provides non-clinical support for the policies and… 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
- Devereux Advanced Behavioral Health (Viera, FL)
- …our team where you can take your career to the next level. **Being the Utilization Review Coordinator at Devereux has its Advantages!** Devereux Florida is a ... to less restrictive environments with ongoing family involvement and support. As the Utilization Review Coordinator at Devereux Florida, you will work with other… more
- Georgetown Behavioral Health Institute (Georgetown, TX)
- …a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator . This position is responsible for working with ... Knowledgeable of insurance coverage and billing practices preferred. Previous experience in utilization review or case management desirable. + Knowledge, Skills… more
- Henry Ford Health System (Troy, MI)
- …other delegated pharmacist. Facilitates the operations of the Pharmacy Care Management Department by organizing, improving, and implementing pharmacy benefit ... management policies and procedures. Major areas of responsibility include...Additional Information + Organization: Community Care Services + Department: Pharmacy- Utilization Mgmt + Shift: Day Job + Union Code:… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS. ... and the TRICARE Operations Manual (TOM) access to care standards for appropriate utilization of services. Perform utilization management /review for medical… more
- LifeCenter Northwest (Bellevue, WA)
- … (OUM) provides strategic leadership and operational oversight for the Organ Utilization Coordinator Team (OUCT), directing key aspects of abdominal organ ... Responsibilities + Lead and engage daily with the Organ Utilization Coordinator (OUC) team in donor case...or operational needs. + Collaborate with the Director, Organ Utilization , to manage departmental budgets and identify cost- management… more