- Fallon Health (Worcester, MA)
- **Overview** **The UM Inpatient Service Coordinator is a telphonic role working with hospital offices regarding inpatient or hospital stays processing prior ... and Post-Acute authorization request data and disseminates information to the Utilization Nurses for review . Additionally, supports the authorization process… 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+...member program engagement. + 20% Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit… 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 ... accordance with the utilization requirements and 3rd party payor contracts. The UM department is responsible for LOS and Level of Care to provide effective and… more
- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate ... timely follow through. | Reviews providers' requests for services and coordinates utilization /appeals management review . | Assist Utilization and Appeals… more
- Tenet Healthcare (Detroit, MI)
- …impact of care options May, if licensed RN, oversee work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator . (10% daily, essential) ... Group Director Utilization Review - 2506000536 Description :...developing and maintaining procedure manuals for such activities as: UM annual work plan/evaluation and quarterly and semi-annual … more
- Sharp HealthCare (San Diego, CA)
- …roundsReviews every patient under assigned workload initially and reviews based on review of care plan.Makes rounds and sees every patient identified per ... departmental guidelines during hospital stay beginning with the admission review of the case manager and reviews with the Case Manager Lead, as needed.Keeps SRS… more
- Bassett Healthcare (Cooperstown, NY)
- …a principle liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate bed ... with medical staff regarding status, placement, payor requirements, and utilization of resources Identifies patient for readmission risk and...status and level of care matches order Collaborates with UM Nurse to assure that all payor and status… 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 ... **Responsibilities** The Care Coordinator RN is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… more
- Dignity Health (Arroyo Grande, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… more
- Dignity Health (Santa Maria, CA)
- …90 days of hire. + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... **Responsibilities** The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these… more
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