- University of Rochester (Rochester, NY)
- …patient care , process, and system issues (hospital and external) related to the care of the patients. Analyzes reports and clinical data to identify trends ... the application of strict inclusion/exclusion criteria and protocols. Performs meticulous chart review and enters clinical data into the quality databases to… more
- Mount Sinai Health System (New York, NY)
- …safely and competently. Effectively leads the team while promoting efficiency in utilization of both personnel and non-personnel resources. Works with the Chief, ... professional and personal development and handle confidential information. Responsible To: Clinical responsibility and oversight falls under the Chief and Chairman… more
- Healthfirst (NY)
- The Case Manager, Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review , discharge ... Monitors assigned case load to meet performance metric requirements + Functions as a clinical resource for the multi-disciplinary care team in order to maximize… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …Leads interdisciplinary complex care management rounds. + Provision of clinical oversight and leadership to Utilization Management/Case Management (UM/CM) ... across the UM/ CM staff. + Participates in clinical peer review recruitment and supervision. +...Carve-In program members meets the standards for acceptable medical care + Fosters Clinical Practice Guideline implementation… more
- Evolent (Albany, NY)
- … expertise in developing cardiovascular programs that include improvements to clinical effectiveness of utilization management (UM) and risk-based models.** ... Process improvement and enhancement of **provider engagement to help ensure high value care delivery.** + Offer ** clinical rationale for standard and expedited… more
- New York State Civil Service (Albany, NY)
- …Title Mental Hygiene Program Evaluation Specialist 3 Occupational Category Health Care , Human/Social Services Salary Grade 23 Bargaining Unit PS&T - Professional, ... Description This position is in the Bureau of Statewide Clinical Programs (BSCP) in the Division of Statewide Services....in the analysis of data to inform policy, service utilization , and/or management decisions related to IPSIDD and Article… more
- University of Rochester (Rochester, NY)
- …inspection of attributes for drug products, packaging and labeling components and assembled clinical supplies. + Incoming inspection and review of all labeling, ... support to software set-up / model verification in the utilization of ClinPro LBL (TM) computerized clinical ...CMSS documents. + With oversight from functional manager, conduct review and approvals of Processing Orders and Clinical… more
- Veterans Affairs, Veterans Health Administration (Montrose, NY)
- Summary The Advanced MSA coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization ... flexibility in the use of a wide range of clinical flow processes relating to access to care...Coordinates with the patient care team to review clinic appointment availability/ utilization to ensure that… more
- Humana (Albany, NY)
- …insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization, ... MD or DO degree + 5+ years of direct clinical patient care experience post residency or...region or line of business. The Medical Director conducts Utilization Management of the care received by… more
- New York State Civil Service (Syracuse, NY)
- …research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or ... Developmental Disabilities, Office for Title Psychologist 1/2 Occupational Category Health Care , Human/Social Services Salary Grade 21 Bargaining Unit PS&T -… more