- Guthrie (Corning, NY)
- …who demonstrates leadership and autonomy in nursing practice. Preferred experience with care management/ utilization review , and payer knowledge. Fast paced ... Up To $25,000 Sign On Bonus For Qualified RNs! Summary: The Care Coordinator-Transitional Care provides telephonic outreach to all patients that have been… more
- Comunilife (New York, NY)
- …Program Director to assure quality program service delivery and participates in Utilization Review /Quality Improvement process. + Participate in case finding, ... Care Coordinator- Care Coordination Job Details Job...Health Information Technology (HIT) to prepare initial and ongoing clinical and psychosocial assessments of service needs to identified… more
- Elderwood (Waverly, NY)
- …HMO Managed Care Insurance Companies + Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review . Managed Care Coordinator ... Salary $ 20 / $ 22 Overview Managed Care Coordinator Overview Mon-Fri 8am-4pm The Managed ...Party appeals, peer to peers as applicable and with clinical oversight provided by the LPN/RN MDS Coordinator. Attends… 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: 1190 ... Partners with Social Workers and collaborates with other health care team members to identify appropriate utilization ...necessity, appropriateness of admission, continuing stay and level of care using a combination of clinical information,… more
- New York State Civil Service (Albany, NY)
- …improvement, focus on prioritization and areas to be addressed through collaborative review and utilization of available data.* Serve as physician advisor ... collaborating with other subject matter experts when reviewing service authorization and utilization data, make recommendations regarding the clinical needs and… more
- Humana (Albany, NY)
- …insurance, other healthcare providers, clinical group practice management + Utilization management experience in a medical management review organization, ... participate in meetings involving care management, provider relations, quality of care , audit, grievance and appeal and policy review . The Behavioral Health… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians ... experience in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly preferred. Home… more
- CVS Health (Ballston Spa, NY)
- …and labeling. + Check for appropriateness of therapy through prospective drug utilization review including assessment for appropriateness of therapy, high risk ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Catholic Health Services (Melville, NY)
- …knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical documentation. Works ... York, as applicable. Certification by American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) preferred. 4. Knowledge, Skills and… more
- Guthrie (Corning, NY)
- …ongoing interaction with the patient and family/caregivers, physician and other health care providers to achieve designated clinical , operational and financial ... to the case management process. Certified to complete Patient Review Instruments (PRIs). Has a working knowledge of the...PRI and other referral procedures as needed for continuing care needs. e) Provides leadership for clinical … more