- Hackensack Meridian Health (Belle Mead, NJ)
- …resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting ... and serve as a leader of positive change. The Utilization Management Coordinator utilizes clinical knowledge and...transition to alternative levels of care. + Perform concurrent utilization review applying identified criteria at prescribed… more
- Humana (Baton Rouge, LA)
- …our caring community and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization management. The UM ... and computational tasks working on semi-routine and patterned assignments. The UM Administration Coordinator 2 provides non-clinical support, following… more
- ManpowerGroup (Columbia, SC)
- **Title:** **Managed Care Coordinator UM II** **Location: Columbia SC (Onsite)** **Duration: 3 months** **Pay Range : $31/hr (On W2)** We are looking for a " ... **Managed Care Coordinator UM II** "to join one of...mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4… more
- Tenet Healthcare (Detroit, MI)
- …of care and appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. (5% daily, ... RN Utilization Review Full Time Days -...an authorization process Closes open cases on the incomplete UM Census Completes the Medicare Certification Checklist on applicable… more
- Huron Consulting Group (Chicago, IL)
- …on established criteria and guidelines. + Maintain accurate and detailed records of review decisions and interactions in the utilization management system. + ... the expert you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate utilization … more
- Access Dubuque (Dubuque, IA)
- …payers to assist in planning and executing a safe discharge. + Collaborate with Utilization Management team on continued stay review . + Educates patients and ... RN-Care Coordinator **UnityPoint Health Finley Hospital** 1 Positions ID:...education. ** Utilization Management/Revenue Cycle** + Applies the utilization management ( UM ) plan by functioning in… more
- Dignity Health (Northridge, CA)
- …and Federal or State regulations pertaining to their practice. + Have an understanding of Utilization Review to progress plan of care. + Performs other duties as ... Certification preferred + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …located within hospital + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. Preferred + Bachelor's Degree in Nursing ... adoption assistance, annual bonus eligibility, and more! **Responsibilities** The Care Coordinator RN is responsible for overseeing the progression of care and… more
- Catholic Health Initiatives (Omaha, NE)
- …pertaining to their practice. 13. Performs other duties as assigned, including utilization review as necessary. **Qualifications** + Graduate of an accredited ... **Overview** The RN Care Coordinator is responsible for overseeing the progression of...will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post… more
- Robert Half Office Team (Bakersfield, CA)
- …Requirements Minimum: 1 year of experience performing non-clinical functions for prospective UM review . Preferred: 1 year of experience providing supportive or ... and accurate manner consistent with policies and procedures as described in the Utilization Management plan. The Clinical Administrator Coordinator role offers a… more