- Elevance Health (Latham, NY)
- …the medical necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts ... preferred. + Extensive spine surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. + **Orthopedic… more
- Highmark Health (Buffalo, NY)
- …in Enrollment + 3 years in Benefits Administration + 3 years in Utilization Management **Preferred** + None **LICENSES AND CERTIFICATIONS** **Required** + None ... Service + Billing Systems + Benefit Coding + Enrollment Systems + Utilization Management Systems **Language (Other than English):** None **Travel Requirement:**… more
- Crouse Hospital (Syracuse, NY)
- …area preferred. + Three (3) - Five (5) years acute hospital experience. + Case Management or Utilization Management experience preferred. Benefits ... Coordination Services team is hiring a Care Manager to review the services delivered to patients and compare it...maintaining the quality of care. + Participates in the utilization management process using standards of care… more
- CAMBA (Brooklyn, NY)
- …staff to excel. + Ensure that all direct reporting staff completes all necessary case management documentations including individual and group case ... analyze incidents and assist in incident debriefings including; providing crisis management assistance, interventions, and follow up with clients who have patterns… more
- New York State Civil Service (Orangeburg, NY)
- …Worker will serve as a member of a multidisciplinary treatment team and management team. The incumbent will function as the primary clinician responsible for ... may include, but are not limited to:* Interview clients and review medical/psychiatric history, and complete various assessments as part of treatment… more
- University of Rochester (Rochester, NY)
- …meetings to review policy, and procedures as well as conduct case reviews. + Participate in educational and wellness opportunities **Other duties as assigned, ... patients within the structure of a comprehensive treatment plan. Demonstrates utilization of evidence-based practices and listening skills, empathy, and supportive… more
- Nuvance Health (Poughkeepsie, NY)
- …, and patient education to improve self- management of chronic disease. 8. Utilization Review Care Coordinators reviews all admissions and continued stays for ... of selected chronic conditions. Broad based clinical background and hospital case - management or Crisis Intervention experience, behavioral health community… more
- Independent Health (Buffalo, NY)
- …credentials preferred. + Four (4) years of clinical experience required. Utilization Management experience preferred. + Comprehensive knowledge and experience ... **Overview** The Clinical Reviewer will be responsible for the collection and review of medical records specific to quality complaints/grievances and appeals as… more
- Bronx County District Attorney's Office (Bronx, NY)
- …but not limited to creating case folders, navigate the digital management systems, review motions and applications, conduct legal research, draft the ... topics. + Monitor Bureau training coordinator's tasks, staff productivity and work utilization information. + Stay informed about changes in the law and brief… more
- New York State Civil Service (Scotia, NY)
- …Duties Description The Maintenance Supervisor 4 is responsible for the management , supervision, coordination, technical direction and daily oversight for the ... Develop Standard Operating Procedures where applicable.* Participate in energy management and consumption, including recommendation for changes and upgrades for… more