- CenterLight Health System (Ridgewood, NY)
- …five (5+) years of experience in care/ case management , disease management , population health management , utilization review , quality assurance, ... clinical onboarding and reassessment, UAS-NY completion, comprehensive assessment, medication review , and post-hospital discharge evaluation. The Clinical Assessment Manager… more
- FlexStaff (New York, NY)
- …five (5+) years of experience in care/ case management , disease management , population health management , utilization review , quality assurance, ... clinical onboarding and reassessment, UAS-NY completion, comprehensive assessment, medication review , and post-hospital discharge evaluation. The Clinical Assessment Manager… more
- Mount Sinai Health System (Long Island City, NY)
- …and manage departmental activities involved in utilization review , appeals management and discharge planning to facilitate the case management ... nursing or healthcare-related field **Experience Requirements** 5 years of Case Management and 6 years of clinical...services by focusing on patient processes. 8.Develops and implements Utilization Review (UR) based on internal data… more
- Mohawk Valley Health System (Utica, NY)
- PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the level of ... specialist regarding correct level of care and reimbursement. Apply knowledge of utilization review , discharge planning, patient status changes, length of stay,… more
- Catholic Health (Buffalo, NY)
- …acute care RN experience required + Preferred prior insurance /managed care/ utilization review experience in the role of a Case Manager or Disease Manager, ... member of the Care Management and interdisciplinary care team, provides comprehensive case management and discharge services to patients and families in the… more
- Centene Corporation (New York, NY)
- …Assume VPMA responsibility in absence of VPMA. + Provide medical leadership for all utilization management , pharmacy, case management , disease ... , cost containment, and medical quality improvement activities. + Perform medical review activities pertaining to utilization review , quality assurance,… more
- CenterWell (Hauppauge, NY)
- …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...of care analysis to determine efficiency, the efficacy of case management system as well as any… more
- Evolent (Albany, NY)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to ... on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Ellis Medicine (Schenectady, NY)
- …plan, implement and evaluate individual healthcare needs. Integrate Discharge Planning, Utilization Review and Performance Improvement activities at the patient, ... levels. Efficiently and effectively anticipates, identifies and resolves issues through utilization review and discharge planning processes. Collaborates with… more
- Rochester Regional Health (Rochester, NY)
- …Provides proactive case coordination/patient navigation for patients, including triage management , algorithm management , utilization management and ... and assist with continually improving the quality and effectiveness of case management /patient navigation. RESPONSIBILITIES + Reviews the medical record… more