- Mount Sinai Health System (New York, NY)
- …limited to: 1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using ... Manager (CM) will be responsible for all aspects of case management for an assigned group of...in homecare, long term care or utilization review preferred. + Discharge Planner or Case … more
- Arnot Health (Elmira, NY)
- …Up to $10,000 Sign on Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for ... is not to be considered inclusive of all duties that may be assigned. MEETINGS: Case management staff meetings. Case management staff development… more
- Healthfirst (NY)
- The Case Manager, Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review , discharge ... planning, and case management as assigned. The Case Manager, Utilization Management is also responsible for efficient utilization of health… more
- Crouse Hospital (Syracuse, NY)
- …day management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... State + Bachelor's degree + Five (5) years previous case management / discharge planning in an acute...acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical,… more
- Stony Brook University (Stony Brook, NY)
- … Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... RN Case Manager **Position Summary** At Stony Brook Medicine,...cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to… more
- Nuvance Health (Poughkeepsie, NY)
- …or BSN preferred. Must have current RN license. Preferred experience in Utilization Review / Management .Company: Vassar Brothers Medical Center Org Unit: ... The Nurse Case Manager role provide clinically-based case management to support the delivery of...physiological and economic perspectives. Has overall accountability for the utilization management and transition management … more
- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role Brighton Health Plan Solutions (BHPS) provides Case Management services to its clients. Cases are maintained by the Nurse Case manager. The ... Case Manager reports to the Manager of Case Management . Responsible for developing and managing...Management . * Determines appropriate care level and resource utilization for complex cases. * Facilitates discharge planning and… more
- CVS Health (Albany, NY)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... overcome barriers to meeting goals and objectives. + Utilizes case management processes in compliance with regulatory...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Stony Brook University (Stony Brook, NY)
- …use of resources. + Oversee staff performance including new staff orientation + Knowledge of Utilization Review and LOS + Review of high-risk complex cases. ... Master's Degree, + Certified RN, + CM Five years Case management experience + Recent tertiary care...or for a maximum of 90 days. An initial review of all applicants will occur two weeks from… more
- MVP Health Care (Rochester, NY)
- …in every interaction **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that ... Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months after...the coordination of quality cost effective care. + The Case Manager will also monitor and review … more