- Fallon Health (Worcester, MA)
- …requests for maternity, acute, subacute and discharge planning requests for all Utilization Management requests * Upload clinical to correct authorization, ... **Overview** **The UM Inpatient Service Coordinator is a...setting or physician's office; knowledge of managed care and/or utilization management strategies advisable * High level… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review/case management /clinical/or combination; 2 of the 4 ... **Job Title:** **Registered Nurse UM II** **Location: Columbia SC 29229** **Duration: 3+ month's Contract** **Job Description:** + Reviews and evaluates medical or… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …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
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The RN Utilization Management Nurse Coordinator is responsible for both concurrent and ... utilization requirements and 3rd party payor contracts. The UM department is responsible for LOS and Level of...to meet targets. + Participates in all aspects of utilization management . Assist with strategies, plans and… more
- Catholic Health Services (Melville, NY)
- … and Appeals Coordinator will perform activities to help facilitate utilization management and appeals functions to include coordination of specific process ... payment related activities. Position Responsibilities: | Prepares necessary documentation for utilization management and appeals processes, performs data … 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
- Tenet Healthcare (Detroit, MI)
- …Mgt. Leaders relating to Case Management scope of services, including utilization management , transition management promoting appropriate length of stay, ... and safe and timely patient throughput. Will integrate national standards for utilization management supporting medical necessity and denials prevention. … more
- Bassett Healthcare (Cooperstown, NY)
- …best quality of life possible. What you'll do The Unit Clinical Care Coordinator RN Unit C3 acts a principle liaison between emergency services, surgical services, ... nursing, finance, physicians, utilization review and medical records to ensure appropriate bed...to each patient. Clinical and Technical Responsibilities: Provides case management services as appropriate throughout the life span and… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and ... **Responsibilities** The Care Coordinator RN is responsible for overseeing the progression...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more
- Dignity Health (Oxnard, 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
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