- University of Rochester (Albany, NY)
- …with patients, families, third-party payers, governmental agencies, employers, social work, financial case management , clinical team and contracting. The ... regulations for the coordination of benefits. + Notify Utilization Management of clinical requests by third party...implement a plan to successfully resolve issues. + Utilize resources and investigational skills to solve unique and complex… more
- Concern For Independent Living (Brooklyn, NY)
- …+ Facilitate residents' linkage with services available in the community (eg, case management , clinical services, day programs, vocational services ... Service Coordinator to be responsible for providing linkages with community resources , daily living skills training, counseling and support, documentation, and… more
- Concern For Independent Living (Hempstead, NY)
- …+ Facilitates residents' linkage with services available in the community (eg, case management , clinical services, day programs, vocational services ... Service Coordinator to be responsible for providing linkages with community resources , daily living skills training, counseling and support, documentation, and… more
- Living Resources (Albany, NY)
- …Health Supervisor Albany, NY (http://maps.google.com/maps?q=Albany+NY+USA+12203) Description Living Resources is a non-profit agency dedicated to providing ... for people with developmental disabilities in safe and nurturing environments. Living Resources ' purpose is to provide high quality care, protection and growth… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …I + Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review activities include: reviews of requests ... review determinations with providers and external physicians. + Conduct clinical appeal case reviews and may require...Qualifications) + Minimum 2-3 years of experience in medical management , utilization review and case management… more
- Elevance Health (Middletown, NY)
- …of caller's situation using established criteria and protocol. + Coordinates with case management and/or staff physicians. + Utilizes established software, ... member of the Elevance Health family of brands, offering clinical programs and primary care options for seniors. We...with the development of policies and procedures. **Nurse Demand Management Sr:** + Serves as a resource … more
- CVS Health (New York, NY)
- …members and providers. Leads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business ... clinical quality and effective use of health care resources . **This is a remote based (work at home)...direction in support of medical management programs through participation in clinical team… more
- Hillside Family of Agencies (Fairport, NY)
- …mentor Clinician I staff as assigned. This clinical position provides counseling and case management services in a program in which every student has an ... Functions + Assess Hillside youth and family needs through clinical interventions to treat and achieve positive outcomes. +...+ Assess and facilitate referrals to Hillside services and resources . + Facilitate individual and group therapy, as well… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and leadership to the daily activities of the Utilization Management Department clinical staff. Acts as resource to Utilization Management staff, members ... cases to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as… more
- Mercy Haven Inc. (Islip Terrace, NY)
- …guide individualized care. + Help individuals connect with community services such as case management , clinical care, day programs, and vocational ... Wellness Specialist. This role is responsible for providing access to community resources , daily living skills training and support surrounding wellness for those… more