- Highmark Health (Albany, NY)
- …manage an active case load of members in his/her panel that are enrolled in case management . The incumbent conducts outreach to members enrolled in case ... **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job has primary...regulatory agency requirements and applicable standards of practice for case management including those published by CMSA… more
- Arnot Health (Elmira, NY)
- Job Description MAIN FUNCTION: The Case Manager coordinates,...is BSN prepared will be a leader in the Case Management practice. The Case Manager ... procures services resources for and manages the care of complex patients to facilitate achievement of quality and cost,...the guidelines. ** 3. Identifies the appropriate patients for Case Management services. ** 4. Maintains a… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Job Description : Summary: This position serves as the expert and leader for case management activities and overall coordination within the Case ... position oversees the clinical and administrative operations and implementation of Case Management activities, including systematic approaches to improve member… more
- Mount Sinai Health System (New York, NY)
- **Job Description ** The Assistant Director of Case Management supports the Director of Case Management with the overall operation of the Case ... efficient care to patients, the delivery of comprehensive front-line Case Management services, including utilization management...for all people, everywhere, by taking on the most complex health care challenges of our time - discovering… more
- Guthrie (Binghamton, NY)
- …care setting with strong care management , utilization review, and payer knowledge. A Case Management certification or obtain a Case Management ... case reimbursement. a) Identifies cost/clinical outlier patients for intensive case management and facilitates evaluation of alternative care options. b)… more
- Mount Sinai Health System (New York, NY)
- **Job Description ** **RN/ Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case ... NYSNA-MSH NYSNA at Mount Sinai Hospital , 329 - Case Management - MSH, Mount Sinai Hospital...for all people, everywhere, by taking on the most complex health care challenges of our time - discovering… more
- Guthrie (Corning, NY)
- …assigned. Has an understanding of the regulatory requirements relative to the case management process. Certified to complete Patient Review Instruments (PRIs). ... of the hospital computer system as it relates to case management . Essential Functions: 1. Assists to...care needs. e) Provides leadership for clinical staff regarding complex patient care concerns and/or care of patients who… more
- Mount Sinai Health System (New York, NY)
- **Job Description ** **Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... Third Party Payor requirements preferred. Non-Bargaining Unit, 329 - Case Management - MSH, Mount Sinai Hospital...for all people, everywhere, by taking on the most complex health care challenges of our time - discovering… more
- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description : Summary: Conducts case management...and supporting systems. + Expertise in Case Management area and able to handle complex ... case management , as outlined in the Case Management Program Description . Opens...improvement suggestions and participates in the solutions of more complex issues/activities. + Mentors junior staff and assists with… more
- Molina Healthcare (New York, NY)
- …have knowledge of available BH services/resources and community resources for adults. Case management and managed care experience is strongly preferred. Further ... site of service. This position will be supporting our Complex Adult Behavioral Health Care Management program....per regulated timelines and determines who may qualify for case management based on clinical judgment, changes… more