- 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
- Humana (Frankfort, KY)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a UM Administration Coordinator 2 who will contribute to the administration of ... utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support… more
- Humana (Jackson, MS)
- …a part of our caring community and help us put health first** The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ... for some opportunity for interpretation/deviation and/or independent discretion. + Provide LTSS UM support by managing shared mailboxes and entering data into work… more
- University of Miami (Miami, FL)
- …time Recovery Coordinator 1 to work in Miami, FL. The Recovery Coordinator 1 ( UM LAORA) assists in the recovery, packaging, preservation and transportation ... of cadaveric organs to be used in surgical transplants. The incumbent also helps to ensures organ recovery activities are in accordance with all applicable regulatory standards and operating procedures. Also, this employee provides preservation support for… 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
- Pomona Valley Hospital Medical Center (Pomona, CA)
- …The Licensed Vocational Nurse plays a vital role within the Case Management Department. The LVN within the Utilization Management team collaborates closely with Case ... Managers, support staff, insurance payers, and post-discharge vendors to ensure safe, timely, and efficient transitions of care. This coordination not only supports optimal patient outcomes but also helps ensure appropriate hospital reimbursement for services… more
- Dragonfly Health (Mesa, AZ)
- …**Essential Functions** **_Note:_** _The essential duties and primary accountabilities below are intended to describe the general content of and_ _requirements of ... this position and are not intended to be an exhaustive statement of duties. Incumbents may perform all or_ _most of the primary accountabilities listed below. Specific tasks, responsibilities or competencies may be documented in the incumbent's performance… 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
- Dartmouth Health (New London, NH)
- …days of admission. Initiates discharge planning process. Maintains communication with UM coordinator regarding assessments, outcomes, and projected lengths of ... stay. Serves as a resource to the healthcare team, communicating with the physician, consultants, and all members of the healthcare team. Participates with the physician/multidisciplinary to review the plan and progress of care, to evaluate the effectiveness… 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. + ... Denial Management Activities + Assists Denial Management staff with clerical support; including facilitating MD to MD reviews. + Performs audit activities under the supervision of the Director of Case Management and Social Work Services. Ellis Medicine is… more
Related Job Searches:
Bilingual Telephonic UM Coordinator,
Coordinator,
Prior Authorization UM Coordinator,
Senior UM Coordinator,
UM Coordinator Inpatient Case,
UM Coordinator Utilization Review