- Arnot Health (Bath, NY)
- …care planning meetings for the long term care unit as appropriate/required. + Assists clinical staff with documentation for MDS based Case Mix to ensure ... of the Long Term Care Department. + Ensures the utilization of the nursing process in maintaining quality of...staff and students by maintaining knowledge and expertise to clinical area. PROFESSIONAL PERFORMANCE: + Observes Medical Center dress… more
- Healthfirst (NY)
- …before commencement of employment. **Preferred Qualifications:** + BA or BSN + Relevant clinical experience such as previous care or utilization management, home ... Reassessment Nurse operations such as overseeing scheduling and staffing, providing clinical consultations, and ensuring departmental productivity goals are met in… more
- Highmark Health (Albany, NY)
- …in Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical , case / utilization management and/or disease/condition management experience, ... Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an...and federal law standards and are within the care manager 's professional discipline. + For assigned case … more
- Rochester Regional Health (Rochester, NY)
- …medical necessity in the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization , performing continued ... in daily Huddles, providing ongoing communication to the Charge Nurse and Nurse Manager to address complex clinical issues, system barriers, and patient/family… more
- Elevance Health (Latham, NY)
- …interventions. **How you will make an impact:** + Ensures timely completion of clinical case reviews for their board certified specialty. + Makes physician ... and CMS Coverage Determinations, as applicable. + Perform physician-level case review of utilization requests for procedures...profession. + Minimum of 1 year of experience with clinical case reviews for medical necessity. _The… more
- Elevance Health (Latham, NY)
- …necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts peer-to-peer ... ** Clinical Operations Associate Medical Director** **Orthopedic Surgery** **Virtual**...+ Extensive orthopedic surgery experience preferred. + Experience with utilization management, especially with CMS guidelines preferred. For candidates… more
- Kaleida Health (Buffalo, NY)
- …degree in Nursing required within five (5) years of hire to the position. Certified Case Manager (CCM) preferred. Employees in the job title prior to 3/29/10 are ... acute care Nursing Experience required. 2 years of experience in any combination of case management, home care and utilization review preferred. Knowledge of and… more
- Trinity Health (Albany, NY)
- …program benefits and services and post-acute care services + Serves as the liaison case manager with the internal and external case managers to ... Primary responsibility is to provide on-site support and assistance to hospital case management and hospitalist team to ensure timely identification of inpatients… more
- Albany Medical Center (Albany, NY)
- …offers comprehensive HIV services including primary medical care, medical case management, medication adherence, peer services, substance abuse counseling, mental ... services, Hepatitis B and Hepatitis C management/ treatment, referral to clinical trials, pre-exposure prophylaxis (PrEP), post exposure prophylaxis (PEP), and HIV… more
- Catholic Health (Buffalo, NY)
- …for clinical performance and process improvement and provides operational and clinical support to the site Office Manager . The Care Coordinator oversees ... of (1) year experience as a registered nurse required + One year previous case , disease, or utilization management experience preferred + One year previous… more
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