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The hospital was the nation’s first behavioral health care center to open a retail pharmacist operated, long-acting injection clinic. The Utilization Review coordinator performs activities which support the Utilization Management functions.
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By using Interqual criteria, policies, regulatory guidelines and other standards of care, the Coordinator for Utilization Management (UM) will collaborate with other health care providers to evaluate the appropriateness of utilization and the medical necessity of care, for elective and emergency admissions, surgeries, diagnostic procedures and treatments.
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Under the general direction of the UM Outpatient Manager and Supervisor, the Outpatient UM Coordinator, is a high paced position that requires timely processing of authorization requests, verifying eligibility and obtaining additional information as requested by Medical Management or Utilization Management Nurses.
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More than 1,200 employees spread throughout its 17 locations, work for the Oswego Health system, which includes the 164-bed community hospital with a brand new Medical Surgical Unit, a 32-bed state-of-the-art psychiatric acute-care facility with multiple outpatient behavioral health service locations, The Manor at Seneca Hill, a 120-bed skilled nursing facility, and Springside at Seneca Hill, an independent retirement community.
$28 - $34 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Remote Utilization Management Nurse will be serving as an essential bridge between health care and medical coverage. Responsibilities of the Remote Utilization Management Nurse:Responsible for performing medical reviews to assess, and coordinate quality care for patientsDetermine medical necessity utilizing MCG criteria and medical policy/contractual benefits.
$79,000 a yearFull-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The RN Utilization Review Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. Three to Five years experience in case management or utilization review or proven success as Registered Nurse Utilization Review I role.
$31.7 - $42.35 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Minimum three years progressive professional experience in health care, including a minimum of two years in a grievance and appeals or related area such as medical or utilization management required.
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Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator.
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The Care Management Nurse, MDS Nurse works the RAI process and conducts assessments and care plan coordination for those residents assigned. Ciena Healthcare is Michigan’s largest provider of skilled nursing and rehabilitation care services.
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Completes the MDS, CAA's and care plans within regulated time frames. Discusses resident care needs with care givers, including physician, nursing, social services, therapy, dietary, and activity staff.
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Coordinates, identifies, and/or initiates significant change MDS’ - Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator - Remains current with American Association of Nursing Assessment Coordinators (AANAC) requirements.
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Responsibilities: Provide direct services in all behavioral health programs, which include, but are not limited to mental health counseling, substance abuse/addictions, elder care, admissions, emergency preparedness and other special programs and projects.
$68,000 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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360 Behavioral Health provides exceptional care for individuals with autism and developmental delays. Effective Communication: 360 Behavioral Health will, upon request, provide auxiliary aids and services leading to effective communication for people with disabilities, including qualified sign language interpreters, assistive listening devices, documents in Braille, and other ways of making communications accessible to people who have speech, hearing, or vision impairments.
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Assist youth and families to develop youth-centered goals and coordinate services for medical and mental health assistance, AODA services, medication management, education, employment, training, development of social support systems, etc.
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The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management and utilization management.
$52.46 an hourFull-timeExpandApply NowActive JobUpdated Today
behavioral health care management coordinator utilization jobs Company: Hospital For Behavioral Medicine in Maumelle, Arkansas
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