- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management ( UM ) program for all TRICARE eligible beneficiaries within the CMHS. ... **ESSENTIAL DUTIES & RESPONSIBILITIES** + Act as coordinator /liaison with providers, staff and Managed Care Support Contractor...utilization management. + One (1) year of experience in UR/ UM and three (3) years of clinical nursing experience.… more
- ERP International (Anchorage, AK)
- …and databases for community resources. - Integrate CM and utilization management ( UM ) and integrating nursing case management with social work case management. - ... of Veterans Affairs, along with basic knowledge of the Recovery Care Coordinator program. Certification:** o Commission for Case Manager Certification Certified Case… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role The UM Coordinator is responsible for coordinating all aspects of the prior authorization process, including member eligibility and benefit ... verification, gathering necessary clinical information from electronic medical record, and timely communication with members, providers and facility staff. Candidates should possess knowledge of third-party reimbursement regulations and medical terminology.… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role BHPS provides Utilization Review services to its clients. The UM Denials Coordinator supports the Utilization Management function by reviewing ... additional information, or resolve discrepancies prior to letter release. The UM Denials Coordinator reports to the Clinical Services team and performs a range… more
- Humana (St. Paul, MN)
- …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
- 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
- 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
- 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 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 Miami (Miami, FL)
- …of International Health is currently seeking a full time International Patient Coordinator to work in Miami. The International Patient Coordinator , under ... pricing and bundled packages; obtains CPT codes and diagnosis information from UM physicians; obtains letters of agreement and payments from international payers… 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 (Coral Gables, FL)
- …and Teamwork (DIRECCT) we strive to create an environment where everyone contributes to making UM a great place to work. We are one of the largest private employers ... interaction with each other and our stakeholders. General Overview: The Development Coordinator serves as a Development and Alumni Relations (DAR) team point of… 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
- University of Michigan (Ann Arbor, MI)
- Clinical Research Coordinator Associate (Term Limited) Apply Now **How to Apply** A cover letter is required for consideration for this position and should be ... position. **Job Summary** We are seeking a full-time Research Coordinator to join our team! The Suicide Prevention Research...and Suicide Prevention Research Team as well as the UM Institute for Firearm Injury Prevention. Our team conducts… more
- Corewell Health (Grand Rapids, MI)
- …quality requirements. Makes recommendations and provides financial and utilization management ( UM ) information to other members of the care facilitation teams for ... patient population. Makes recommendations and discusses alternatives. Provides financial/DRG, UM , health information to other facilitation team members for work… more
- CommonSpirit Health (Lakewood, CO)
- …help you flourish and leaders who care about your success. The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for ... identified patients requiring these services. The RN Care Coordinator performs this role to meet the individual's health needs while promoting quality of care, cost… more
- CommonSpirit Health (Garden City, KS)
- …help you flourish and leaders who care about your success. The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for ... identified patients requiring these services. The RN Care Coordinator performs this role to meet the individual's health needs while promoting quality of care, cost… more
- Dignity Health (Long Beach, CA)
- …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 ... identified patients requiring these services. The RN Care Coordinator performs this role to meet the individual's health needs while promoting quality of care, cost… more
- Dignity Health (Los Angeles, CA)
- …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 ... identified patients requiring these services. The RN Care Coordinator performs this role to meet the individual's health needs while promoting quality of care, cost… more
- Dignity Health (Long Beach, CA)
- **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients ... requiring these services. The RN Care Coordinator performs this role to meet the individual's health...Certified Case Manager (CCM) Accredited Case Manager (ACM-RN) or UM Certification preferred + Knowledge of managed care and… more
