- Molina Healthcare (Rochester, NY)
- …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case ...EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in… more
- Molina Healthcare (Albany, NY)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Outreach Development Corporation (Richmond Hill, NY)
- …potential. For more information, please visit www.opiny.org. Position: Assistant Program Director CCBHC The Assistant Program Director assists the Program ... for outpatient substance use disorder treatment. Works with the Program Director to develop and implement policies and procedures that encourage effective… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and educational ... Job Description: Summary: Conducts case management program activities in accordance...consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered… more
- CDPHP (Latham, NY)
- …group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and educational ... values and invites you to be a part of that experience. Conducts case management program activities in accordance with departmental, corporate, NYS Department… more
- Albany Medical Center (Albany, NY)
- …to physician and hospital clinical leadership, legal, compliance, billing, finance, IT, case and utilization management , quality, credentialing, and other ... The Director builds external relationships with payers' senior network management , leads meeting, oversees and/or prepares presentations, and is responsible for… more
- Humana (Albany, NY)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Molina Healthcare (Yonkers, NY)
- …health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs ... - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
- Humana (Albany, NY)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , or similar activities **Preferred ... community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare...Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience… more
- Crouse Hospital (Syracuse, NY)
- …licensed as a Registered Professional Nurse in New York State. + Recent acute care Utilization Management and Case Management experience. + Current ... outreach programs. Crouse's Care Coordination team is hiring a Director of Care Coordination. Pay Range: $150,000.00 - $180,000.00...certification in Case Management (CCM or ACM) and/or Health Care Quality (CPHQ)… more