We have other current jobs related to this field that you can find below
-
UM Nurse, LVN
2 months ago
Long Beach, United States Advanced Medical Manage Full timeJob DescriptionJob DescriptionPOSITION SUMMARYReports to the UM Manager. This position is a position for a California Licensed Nurse whose primary responsibilities are to perform the prospective and retrospective review of the requests for service authorizations in order to monitor the continuity and coordination of care and to assist in the utilization of...
-
RN Care Coordinator
3 weeks ago
Long Beach, California, United States Dignity Health Full timeOverviewCommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our...
-
RN Care Coordinator
2 weeks ago
Long Beach, United States Unavailable Full timeOverview CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our...
-
Clinical Audit Coordinator
1 month ago
Long Beach, United States Advanced Medical Manage Full timeJob DescriptionJob DescriptionPOSITION SUMMARYThe Clinical Audit Coordinator, assisting and informing the Manager of any barriers that may preventing tasks from being completed in a timely and efficient manner. Individual must be able to execute effective communications verbally and in writing, maintain patient confidentiality, and promote departmental and...
-
Care Coordinator
2 weeks ago
Long Beach, United States Advanced Medical Manage Full time $20 - $25Job DescriptionJob DescriptionRole InsightsThis role of Care Coordinator is considered an essential position within the organization and Care Management Department. This role is responsible for assisting in the provision of telephonic patient care under the guidelines of AMM and in collaboration with the Care Management Team. This individual must be...
-
Patient Care Coordinator
1 day ago
Long Beach, California, United States Advanced Medical Manage Full timeJob OverviewPosition SummaryThe role of a Care Coordinator is vital within the Advanced Medical Management organization and its Care Management Department. This position is dedicated to facilitating telephonic patient support in accordance with AMM guidelines and in partnership with the Care Management Team. The ideal candidate will exhibit a positive...
-
RN Care Coordinator
3 weeks ago
Long Beach, United States Dignity Health Full timeOverview CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our...
-
Patient Care Coordinator
6 days ago
Long Beach, California, United States Advanced Medical Manage Full timeJob OverviewPosition SummaryThe Care Coordinator plays a pivotal role within the Advanced Medical Management organization, specifically within the Care Management Department. This position is tasked with facilitating telephonic patient support in accordance with established guidelines and in collaboration with the Care Management Team. A positive demeanor,...
-
Patient Care Coordinator
6 days ago
Long Beach, California, United States Advanced Medical Manage Full timeJob OverviewPosition SummaryThe role of a Care Coordinator is pivotal within the Advanced Medical Management organization and its Care Management Department. This position entails providing telephonic support to patients, adhering to the guidelines set forth by AMM, and collaborating closely with the Care Management Team. The ideal candidate will embody a...
-
Radiology Records Coordinator
6 days ago
Deerfield Beach, Florida, United States University of Miami Full timeCurrent Employees: If you are currently employed at the University of Miami, please log in to Workday to utilize the internal application process. For guidance on applying for faculty or staff positions using the Career worklet, please refer to the appropriate resources. The Department of Radiology is actively seeking a Records Assistant (H) to join our...
-
Manager, Certification Programs
2 months ago
Vero Beach, United States Piper Aircraft Full timeJob Description Manager, Certification Programs (Full Time) Department: All Openings POSITION SUMMARY: Manage aircraft certification programs to insure timely completion. Serve as liaison between the Company, the Federal Aviation Administration (FAA) and Foreign Civil Aviation Authorities (FCAA) to assure continued operation under Organization...
-
Principal Integration Architect
1 month ago
Virginia Beach, United States Sentara Full timeCity/State Virginia Beach, VA Overview Work Shift First (Days) (United States of America) The Principal Integration Architect will be responsible for managing the design, development, modification of application integration for payer clinical utilization management platform. This senior technical role is expected to be hands-on in providing...
-
Senior Business Analyst
3 months ago
Virginia Beach, United States Hazen and Sawyer Full timeJob DescriptionJob DescriptionHazen and Sawyer has an exceptional opportunity for a self-motivated and dynamic individual to join our growing Utility Management Solutions Group. This opportunity involves working with multi-disciplinary teams of engineers, planners, and scientists to develop utility management and planning solutions for a wide array of...
-
Case Management
4 months ago
Long Beach, United States Blue Shield of California Full timeYour Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Nurse Consultant will report to the Manager of Care Management for the Population Health Management Medi-Cal Team. In this role, you will ensure that services are...
-
Case Management
1 month ago
Long Beach, United States Blue Shield of California Full timeYour Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures...
-
Case Management
1 week ago
Long Beach, United States Blue Shield of California Full timeYour Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures...
-
Case Management
2 months ago
Long Beach, United States Blue Shield of California Full timeYour Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures...
-
Case Management
3 months ago
Long Beach, United States Blue Shield of California Full timeYour Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures...
-
Case Management
2 months ago
Long Beach, United States Blue Shield of California Full timeYour Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures...
-
Case Management
3 days ago
Long Beach, United States Blue Shield of California Full timeYour Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures...
UM Coordinator
2 months ago
5297 W Copans Rd, Margate, FL 33063, USA
Req #1209
Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and general caregivers 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
Assists in completing authorization updates as needed based on the care plan of the member
Coordinates with providers regarding authorization activities
Coordinates communication between authorization clinical staff, members and providers as needed
Act as liaison and member advocate between the member/family, physician(s) and the care team to ensure timely and effective communication in regards to the members care
Participates in case round meetings and on-going education activities
Ensures that all job responsibilities are carried out in compliance with CPHL and State and Federal regulations
Other assigned duties
EDUCATION AND EXPERIENCE:
Education
Required: HS Diploma
Preferred: Bachelors Degree
Type of Experience
Required:
Strong written and verbal communication skills
Computer proficiency
Preferred:
Experience working within a managed care environment
Specific Technical Skills
Preferred:
Computer proficiency in Microsoft Office applications
Certifications/Licensure:
Required: None
SCOPE INFORMATION
# Direct Reports: 0
PHYSICAL REQUIREMENTS:
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Must be able to operate a computer and telephone
The above statements are intended to describe the general nature and level of work performed by individuals assigned to the job classification. They should not be construed as an exhaustive list of all responsibilities, duties and skills required
Centers Plan For Healthy Living is committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our employees and our business. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law and will not be denied employment.
5297 W Copans Rd, Margate, FL 33063, USA
#J-18808-Ljbffr
