- CenterLight Health System (Flushing, NY)
- …and members' responses to interventions to determine the effectiveness of the plan of care and the utilization of services and implements changes and adjustments ... nursing standards of excellence with advance professional education to deliver high-quality care . Serve the organization as a member of the management team, working… more
- CenterLight Health System (Ridgewood, NY)
- …and members' responses to interventions to determine the effectiveness of the plan of care and the utilization of services and implements changes and adjustments ... nursing standards of excellence with advanced professional education to deliver high-quality care . Serve the organization as a member of the management team, working… more
- University of Rochester (Rochester, NY)
- …individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The CARE Case Manager provides strengths-based assessment, intervention, ... success and to enhance their holistic well-being. The Case Manager exercises independent judgment while coordinating with the Director...students in need of additional support. + Conduct initial review of CARE referrals using the process… more
- Bassett Healthcare (Oneonta, NY)
- …timely and accurate information to payors. The role integrates and coordinates utilization management, care facilitation, and discharge planning functions. The ... ancillary staff to eliminate barriers to efficient delivery of care in appropriate setting. + Completes utilization ...both areas. + Refers cases and issues to Case Review , Utilization Committee, Medical Director, and Director… more
- Molina Healthcare (Rochester, NY)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... and appropriate/accurate billing and claims processing. + Identifies and reports quality of care issues. + Assists with Complex Claim review including DRG… more
- Ellis Medicine (Schenectady, NY)
- …provided by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and ... experience in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly preferred. Home… more
- Elevance Health (New Hyde Park, NY)
- **Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, ... is granted as required by law. The **Behavioral Health Care Manager II** is responsible for managing...outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses… more
- Healthfirst (NY)
- …placement, and/or community-based services and may be called upon to do Utilization Review for those services + Develops care plans that align with the ... of the relevant product line + Relevant work experience preferably as a Care Manager + Demonstrated ability to manage large caseloads and effectively work in a… more
- CenterWell (Westbury, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... at our Westbury, NY branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care ...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- Molina Healthcare (Buffalo, NY)
- …where integrated) performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical ... Health and Long-Term Services & Supports for Molina members. Oversees Interdisciplinary Care Team meetings. + Functions as hands-on manager responsible for… more
Recent Jobs
-
Associate Avionics Technician - F-15
- BOEING (San Antonio, TX)
-
Medical Science Liaison - Psychiatry - Northeast
- Lundbeck (Boston, MA)
-
Field Service Technician I
- Shimadzu Scientific Instruments (NJ)
-
Accounting Specialist
- vaco (Aliso Viejo, CA)