- Excellus BlueCross BlueShield (Buffalo, NY)
- …of clinical oversight and leadership to Utilization Management/Case Management ( UM /CM) staff working with the children's population. + Develops, implements, and ... and coordination between BH and PH care across the UM / CM staff. + Participates in clinical ...with children in BH managed care settings or BH clinical settings (at least two ( 2 ) years… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …drivers. Essential Accountabilities: Level I + Handles physical health member clinical management programs. + Maintains knowledge of current Case Management Society ... or external referral sources. Applies case management criteria and professional clinical judgment to determine a member's appropriateness for case management… more
- Molina Healthcare (Albany, NY)
- …national, state, and local laws and regulatory requirements affecting the medical and clinical staff. MD licenses required for the following states: WA, FL, MI, MS, ... appropriate care at the most effective setting. Evaluates the effectiveness of UM practices. Actively monitors for over and under-utilization. Assumes a leadership… more
- Independent Health (Buffalo, NY)
- …employment. + Two ( 2 ) years of experience in a behavioral health clinical and/or care coordination setting required. + Experience in a health plan/managed care ... licensed family or marriage therapist (LMFT) or active registered nurse (RN) in NYS required. Certified Case Manager (CCM)...a plan of care based upon providers of care clinical assessments and patients, to identified population along the… more