- Elevance Health (Middletown, NY)
- …office visits with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering ... programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical /strategic advisor...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- Elevance Health (New York, NY)
- …Coordinator - RN Telehealth** is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to non-RN ... clinicians participating in the member's case in accordance with applicable state law and contract; develops , monitors, evaluates, and revises the member's care… more
- St. James Hospital (Hornell, NY)
- …information, assigns bed, and lets appropriate staff know. + Assists ED and Med/Surg manager with staff scheduling + Assists case management with completion of ... nursing staff within the facility along with elements of case management. Performs complex and varied tasks requiring independent...+ Serve as a resource to staff for solving clinical issues. + Act as a resource in identifying… more
- Veterans Affairs, Veterans Health Administration (Bronx, NY)
- …programs and is responsible for maintaining the integrity of information in these clinical records. Provides clinical and case -management services through ... for completing the following duties/responsibilities: Completes structured diagnostic and clinical assessments for participants. This requires knowledge of medical… more
- Evolent (Albany, NY)
- …attendance at national oncology- hematology conferences. + This position may also serve as the clinical lead (SME) on the Rules Manager Team. + Ability to travel ... Opportunities:** The Oncology Pharmacist role collaborates with the full clinical team, service organization, performance suite and provider solutions to… more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …with federal and state regulations and company policy and procedures.Acts as in-house case manager by considering all aspects of the residents care and ... that govern the process + Acts as an in-house Case Manager demonstrating detailed knowledge of residents...that allow capture of resources provided on the MDS, clinical trends that impacts resident care, and any additional… more
- Albany Medical Center (Albany, NY)
- …organized and quality documentation as required by the department. + Facilitates the utilization of resources to meet patient outcomes ( case management). + ... Under the Supervision of the Nursing Supervisor and/or Nurse Manager , the RN provides nursing support to primary and...necessity as indicated + Delegates daily tasks to appropriate clinical staff and ensures completion of tasks + Collaborates… more
- Albany Medical Center (Albany, NY)
- …organized and quality documentation as required by the department. + Facilitates the utilization of resources to meet patient outcomes ( case management). + ... Under the Supervision of the Nursing Supervisor and/or Nurse Manager , the RN provides nursing support to primary and...necessity as indicated + Delegates daily tasks to appropriate clinical staff and ensures completion of tasks + Collaborates… more
- Sharecare (Albany, NY)
- …+ Referring members to Clinical Advocates (Nurse) for conditions that require clinical care and case management assistance + Primary duties include but are ... / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, dental, and… more
- Molina Healthcare (Buffalo, NY)
- …and Abilities **Preferred Qualifications:** * Bachelor's degree in Nursing * CCM- Certified Case Manager , CCP - Chronic Care Professional. * Home Care, Long-Term ... Completes approved New York State Comprehensive Health Initial Assessment Tool and/or Clinical Reassessment used to define eligibility for community based long term… more