- Elevance Health (New York, NY)
- **Clinical Operations Medical Director** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Coordination Specialist provides administrative support for any of the programs of Utilization Management , Behavioral Health, Quality Management , or Member ... tasks under pressure. + Demonstrates proficiency in basic navigation and utilization of department specific applications: care management system, department… more
- Global Foundries (Malta, NY)
- …design experience using GF PDK + Silicon Photonic simulation experience + Project management skills - ie, the ability to innovate and execute solutions that matter; ... automatically populate in every external job description. The Hiring Manager only needs to provide the above pieces of...information. Requests for accommodation will be considered on a case -by- case basis. Please note that only inquiries… more
- Kaleida Health (Buffalo, NY)
- …acute care Nursing Experience required. 2 years of experience in any combination of case management , home care and utilization review preferred. Knowledge of ... outcomes for the patient in the acute care setting. Case management is a process that efficiently...five (5) years of hire to the position. Certified Case Manager (CCM) preferred. Employees in the… more
- Elevance Health (New York, NY)
- …individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management , or similar role; or any combination of ... Service Coordinator - RN Clinician** is responsible for overall management of member's case within the scope...co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a thorough and… more
- CenterWell (Albany, NY)
- …prior experienceparticipatingin teams focusing on transitions of care, quality management ,utilizationmanagement, case management , discharge planning and/or ... of business metrics. + Experience working with Casemanagersor Caremanagerson complex case management , including familiarity with social determinants of health.… more
- Molina Healthcare (Buffalo, NY)
- …(CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional ... chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. *… more
- Molina Healthcare (Buffalo, NY)
- …(CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional ... ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS)… more
- Bassett Healthcare (Cooperstown, NY)
- …and elder abuse and neglect, domestic violence and complex care management (when appropriate). Adherence to established Psychiatry Department protocols and (OMH) ... providers to coordinate treatment plan goals and objectives . Participates in case conference treatment team meetings . Treats patients, colleagues, and other staff… more
- Elevance Health (New York, NY)
- …mandated policies, and CMS Coverage Determinations, as applicable. + Perform physician-level case review of utilization requests for procedures and interventions ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more