- Ellis Medicine (Schenectady, NY)
- …beneficiaries per CMS Conditions of Participation at the direction of the Case Manager . * Utilization Management Activities; Collaborates with Case ... Basic Function: The Case Management Associate's primary function is...agencies to make post discharge arrangements for patients. Assists Case Manager or Social Worker by offering… more
- Molina Healthcare (Buffalo, NY)
- …RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional ... or state board licensing mandate. + At least 2 years in case , disease or utilization management ; managed care; or medical/behavioral health settings. + One… more
- Guthrie (Binghamton, NY)
- …and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care ... On Bonus For Qualified RNs! Position Summary: The Acute Case Manager utilizes industry accepted processes for..., utilization review, and payer knowledge. A Case Management certification or obtaining a … more
- Ellis Medicine (Schenectady, NY)
- …Planner's primary function is to work with the Social Worker, Nurse Case Manager , or Utilization Management Nurse to facilitate patient discharge plans, ... per CMS Conditions of Participation at the direction of the Case Manager . + Utilization Management Activities: + Collaborates with Case Managers and… more
- Helio Health Inc. (Syracuse, NY)
- …efforts to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ... by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case /Care Management Position Type Full-Time Work Arrangement Onsite ID 2025-5930 more
- Excellus BlueCross BlueShield (Rochester, NY)
- …cases to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as ... depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/ Case Manager MSH Case Management PT Days** The Case Manager (CM) will be responsible for all aspects of case ... utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ...patients where utilization review, discharge planning, and/or case management will be needed using standardized… more
- Molina Healthcare (Yonkers, NY)
- …the pharmacy benefit changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary care team. ... (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy… more
- Guthrie (Corning, NY)
- …RNs! Position Summary: In collaboration with the interdisciplinary healthcare team, the Case Manager will coordinate the flow of services throughout the ... an understanding of the regulatory requirements relative to the case management process. Certified to complete Patient...concise & timely manner as deemed appropriate by the case manager . 3. Identifies individual patient discharge… more
- Bassett Healthcare (Oneonta, NY)
- … utilization management , care facilitation, and discharge planning functions. The Case Manager is accountable for a designated patient caseload and plans ... best quality of life possible. What you'll do The Case Manager RN supports the physician and...efficient delivery of care in appropriate setting. + Completes utilization management and quality screening for assigned… more