- Humana (Frankfort, KY)
- …service telephone experience desired + Experience with Utilization Review and/or Prior Authorization , preferably within a managed care organization **Additional ... health first** Humana Healthy Horizons in Kentucky is seeking a UM Administration Coordinator 2 who will contribute to the administration of utilization… more
- Humana (Jackson, MS)
- …telephone experience desired. + Experience with LTSS Utilization Review and/or Prior Authorization , preferably within a managed care organization. **Additional ... of our caring community and help us put health first** The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring… 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 ... members of the organization. Primary Responsibilities + Research and confirm authorization requirements and communicate to member, providers, and facility staff. +… more
- Centers Plan for Healthy Living (Margate, FL)
- …authorization requests for eligible members. PRIMARY RESPONSIBILITIES: + Assists in the prior authorization of services and ongoing authorization requests ... 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… more
- Fallon Health (Worcester, MA)
- …other applicable regulatory requirements and customer expectations. The FH Authorization Coordinator serves to administer the FH prior authorization ... Coverage, departmental policies and procedures, and regulatory standards. The Authorization Coordinator serves as a liaison between...inquiries + Serves as a primary trainer for all UM Nurses on the prior authorization… more
- Blue KC (Workman, MN)
- …available resources to promote optimal, cost-effective outcomes. Transplant only: Provides prior authorization for, coordinates, and individually manages all ... Prioritizes work appropriately. Additional duties for Transplant only: + Provides prior authorization of the transplant and manages individual member… more
- University of Michigan (Ann Arbor, MI)
- …+ Troubleshoot complex medication-related issues and make suggestions for improvement (insurance/ prior authorization , medication history, etc.) + Identify and ... submission of the following: + Completed application via the UM Careers website + Cover Letter or Letter of...improvements and supports implementation of changes + Owner and coordinator of a senior technician activity: a specific and… more
- Highmark Health (Wexford, PA)
- …bonus for a 1-year commitment This position supports the network centralized prior authorization department. Coordinates and administers the effective and ... efficient processing of the pharmacy benefits prior authorization process, ensuring that pharmacy benefits are administered in accordance with all regulatory… more
- Ellis Medicine (Schenectady, NY)
- …or send for insurance denials or quality improvement organization appeals. + Assists UM Coordinator with data entry of insurance authorizations and denials. + ... as instructed. + Ensure discharge planning documents are provided to post-acute care facilities prior to patient return (ie. NYS Department of Health Forms, etc ) +… more