- Garnet Health (Harris, NY)
- … care from the hospital to home setting. Responsible for discharge planning, utilization review , team conferences and unit based rounds. At Garnet Health, we ... and a rewarding lifestyle. Our focus is on patient-centric care with a collective of visionary leaders and dedicated...make your career home with us as a Case Manager on our Case Management team at/in Garnet Health… more
- New York Edge (Queens, NY)
- …seeking a passionate, knowledgeable, and mission-driven individual to serve as Program Manager of After-School Programs. In this full-time role, you will oversee the ... Compliance, Data, Communications, and Finance-to enhance program efficiency, resource utilization , and cross-functional synergy. Training and Development + Provide… more
- Rochester Regional Health (Rochester, NY)
- …QI and UR reports in a timely manner and participates in QI and Utilization Review processes. + Computer keyboard skills and ability to utilize computers ... Job Title: Manager , Chemical DependencyDepartment: Inpatient Chemical Dependency Location: 16...all other sedentary criteria are met. For disease specific care programs refer to the program specific requirements of… more
- Arnot Health (Elmira, NY)
- …Bachelor's in nursing preferred. Must have proficient writing skills.Experience in Utilization Review and InterQual required. CARDIOPULMONARY RESUSCITATION (CPR) ... Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and retrospective authorization and… more
- Nuvance Health (Carmel, NY)
- …experience in an acute care setting; Leadership experience preferred; Utilization review , discharge planning or case management experience preferred. ... in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a...including The Heart Center, a leading provider of cardiology care . Non-acute care is offered through various… more
- Catholic Health (Buffalo, NY)
- …Two (2) years acute care RN experience required + Preferred prior insurance /managed care / utilization review experience in the role of a Case Manager ... Weekend and Holiday Rotation Hours: 7:30am to 5:30pm/8:00am to 6:00pm Summary: The RN Care Manager , Transition of Care , as an active member of the Care… more
- Molina Healthcare (Yonkers, NY)
- …and facilitates root cause analyses. + Leads internal audits and file review rehearsals. + Ensures survey readiness by maintaining documentation and evidence of ... in healthcare, with 2+ years in health plan quality improvement or managed care . (HIGHLY PREFERRED)** + **Strong knowledge of NCQA standards and EQRO functions.… more
- Molina Healthcare (Albany, NY)
- …process, including HEDIS, state-based measure reporting and medical record review . + Manages annual HEDIS data collection activities. Responsibilities include ... reports including performance measurement rates. + Manages medical record review and performance measurement reporting projects for assigned area(s) ensuring… more
- Sharecare (Albany, NY)
- …individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit ... services + Uses technical and business development skills to increase client's utilization of current technology + Tracks, analyzes, creates, and delivers relevant… more
- STG International (Auburn, NY)
- …* Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... STGi is currently seeking a Primary Care Physician to provide services at our Community...procedures and suggest improvements. * Assist the STGi Program Manager in implementation of Quality Performance Improvement Team (QPIT)… more