- Penn State Health (Hershey, PA)
- … Utilization Management Nurse or Specialist, the Utilization Management Coordinator supports the UM process by obtaining authorizations, reviewing ... or outlaw discrimination._ **Union:** Non Bargained **Position** UM Coordinator - Utilization Management **Location** US:PA: Hershey | Clerical and… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …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
- Humana (Oklahoma City, OK)
- …first** The UM Administration Coordinator 2 contributes to administration of utilization management . The UM Administration Coordinator 2 performs ... support assignments. Performs computations. Typically works on semi-routine assignments. The UM Administration Coordinator 2 + provides non-clinical support for… 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
- 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 ... Utilization Management prior authorization sand appeals. JOB...Maintaining expected timelines EXPERIENCE: + 1 year as a UM Coordinator in a managed care payer… 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 ... in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal… more
- Sharp HealthCare (San Diego, CA)
- …readmissions to acute or visit to the Emergency Department.Informs Director, QI/ UM of any quality issues.Attends hospitalists rounds, as required, to discuss ... high risk patients requiring case management follow up.Attends clinical in-services or required operational/clinical training sessions. + Act as a… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management ( UM ) program for all TRICARE eligible beneficiaries within the ... Operations Manual (TOM) access to care standards for appropriate utilization of services. Perform utilization management...management . + One (1) year of experience in UR/ UM and three (3) years of clinical nursing experience.… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention ... potentially avoidable days Other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical and financial requirements and… 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 ... 10% of salary for this position. The RN Care Coordinator is responsible for overseeing the progression of care...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … 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 ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Cedars-Sinai (Beverly Hills, CA)
- …fuels 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 ... TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of...(Medical Surgical/Tele/ICU) with 2 or more year of care management experience ( UM or DC Planning). +… more
- Community Based Care of Brevard, Inc. (Rockledge, FL)
- …develop an individualized case plan outlining family needs, goals and services. Service Utilization UM /Wrap: This is strongly recommended in order to manage and ... Starting Salary: $49,700/year Position Summary: The Diversion Care Coordinator will be responsible for managing a caseload...application for daily entry of case activity and the utilization management of service authorizations. 2+ years'… more
- Corewell Health (Dearborn, 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
- 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
- Dignity Health (Merced, 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
- Corewell Health (Grand Rapids, MI)
- … management and quality requirements. Makes recommendations and provides financial and utilization management ( UM ) information to other members of the ... to facilitate process improvement and physician education. + Coordinates with care management on admissions, on-going stay UM workflows, authorization, denial,… more
- Dignity Health (Oxnard, CA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... **Job Summary and Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- CommonSpirit Health (Lakewood, CO)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... leaders who care about your success. The RN Care Coordinator is responsible for overseeing the progression of care...hospital clinical experience or a Master's degree in Case Management or Nursing field in lieu of acute experience.… more
- CommonSpirit Health (Garden City, KS)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... leaders who care about your success. The RN Care Coordinator is responsible for overseeing the progression of care...hospital clinical experience or a Master's degree in Case Management or Nursing field in lieu of acute experience.… more