- Molina Healthcare (Albany, NY)
- …Clinical Social Worker/Counseling (or related field) License Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified ... Responsible for the development, implementation, and delivery of training curriculum for Utilization Management , Case Management , and LTSS staff. Leads… more
- Arnot Health (Elmira, NY)
- …processes related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge ... will be a leader in the Case Management practice. The Case Manager ... case managers. f. The Case Manager tracks and trends LOS, resource utilization ,… 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 2025-5227 more
- Catholic Health (Buffalo, NY)
- …prior insurance /managed care/ utilization review experience in the role of a Case Manager or Disease Manager , Population Health, Discharge Planning or ... to 4:00 pm Summary: The Registered Nurse (RN) Care Manager - Utilization Review, as an active member of...or obtained within 6 months + National Certification in Case Management preferred EXPERIENCE + Two (2)… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/ Case Manager MSH Case Management FT 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
- Guthrie (Binghamton, NY)
- …with strong care management , utilization review, and payer knowledge. A Case Management certification or obtain a Case Management certification ... Position Summary: The Acute Case Manager utilizes industry accepted processes...members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria.… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Case Manager is responsible for all aspects of case management / utilization review for an assigned group of inpatients, ED ... management and the transition of care. The Case Manager actively participates in specific clinical... utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager … more
- Guthrie (Corning, NY)
- Position Summary: In collaboration with the interdisciplinary healthcare team, the Case Manager will coordinate the flow of services throughout the patient's ... 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 . Identifies individual patient discharge needs… more
- Molina Healthcare (Rochester, 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
- Mount Sinai Health System (New York, NY)
- …in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5 years? ... **Job Description** The Case Manager (CM) will be responsible...patients where utilization review, discharge planning, and/or case management will be needed using standardized… more
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