- BronxCare Health System (Bronx, NY)
- …and department staff when prevented from completing job tasks. -Assists the Administrative Manager and Director with annual review and revisions of departmental ... Overview The Appeals Manager is responsible to assist in the analysis...denial being overturned providing the hospital reimbursement for the care and services provided to the patient. The Denial… more
- Northwell Health (New Hyde Park, NY)
- …experience post-licensure, with a significant portion (4+ years) directly in a managed care organization, Pharmacy benefit manager , or health plans + Experience ... the development, implementation, and maintenance of drug formularies, clinical utilization management (UM) criteria, and evidence-based drug therapy guidelines, and… more
- Arnot Health (Elmira, NY)
- …to the management of patient care . The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case ... Manager 's average caseload will be: 15-25. The Case Manager will work cooperatively with in the care... rounds and participates in them. . The Case Manager tracks and trends LOS , resource utilization… more
- Nuvance Health (Poughkeepsie, NY)
- …Nursing, BSN preferred. Must have current RN license. *Preferred Experience: * Utilization Review /Management.Company: Vassar Brothers Medical Center Org Unit: ... the assigned caseload. Partners with Social Workers and collaborates with other health care team members to identify appropriate utilization of resources and to… more
- WMCHealth (Valhalla, NY)
- …the procedures specified in the Clinical Care Management Department through review of the Utilization and Discharge Planning Program at Westchester Medical ... Supervisor Of Nursing- Nurse Manager Transplant Company: Westchester Medical Center City/State: Valhalla,...in the Clinical Care Management Department through review of the Utilization and Discharge Planning… more
- Nuvance Health (Carmel, NY)
- …medical provider, the Case Manager RN collaborates with all members of the care team, focusing on the delivery of efficient, high-quality care . This position ... you and your career. Putnam Hospital, a 164-bed acute care hospital, has been serving the local community in...Program (MBSAQIP) * Robotic Center of Excellence - Surgical Review Corporation (SRC) At Putnam Hospital, our team members… more
- CDPHP (Latham, NY)
- …Registered Nurse Case Manager is responsible and accountable for coordinating the care of CDPHP members who meet case management criteria across the continuum of ... fax machine and mail. The Medicaid Special Programs Case Manager typically works in the telephonic managed care...and education regarding plan requirements. + Demonstrated ability to review health care delivery against established criteria… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers ... and collaboration to ensure delivery of consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral… more
- Mount Sinai Health System (New York, NY)
- …for collaboration with appropriate specialty and site-based departments assisting with the care of transplant patients. The program manager will provide ... attends team meetings to enhance an interdisciplinary approach to care delivery. 8. Performs a patient record review...ensure that clinical practice, systems are supportive of clinical care . 15. Promotes utilization of RNs to… more
- Mount Sinai Health System (New York, NY)
- …day functions of health-system throughput, transfer center, quality, and delivery of care . The Clinical Program Manager , Clinical Command Center participates in ... **Job Description** The Clinical Program Manager , Clinical Command Center is a Registered Professional...the health system, in the development, implementation, and ongoing review of policies, procedures, and standards of care… more
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