- Arms Acres (Bronx, NY)
- …life skills) as identified in patient treatment plans and requested by program director . Performs utilization review , provides progress reports and develop ... drugs. Sign-on bonus eligible FUNCTION: To provide comprehensive clinical case management services that include: assessments; individual, group and family treatment;… more
- Arms Acres (Carmel, NY)
- …life skills) as identified in patient treatment plans and requested by program director . Performs utilization review , provides progress reports and develop ... NY. In this role, you will provide comprehensive clinical case management services that include: assessments, individual, group and family treatment, treatment… more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review ... and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a… more
- Stony Brook University (Stony Brook, NY)
- …Coordinate the design, development, implementation, and monitoring of the organization's case management and utilization review functions. + Lead initiatives ... Management leadership and staff functions related to case management and utilization management activities....and collaboration with Social Work Services * Knowledge of Utilization Review and Denial/Appeals * Knowledge of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review activities include: reviews of ... we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of... review determinations. + Provides input into the utilization management program policies and procedures. +… more
- Centene Corporation (New York, NY)
- …functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management...Performs medical review activities pertaining to utilization review… more
- Evolent (Albany, NY)
- …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit… more
- MTA (New York, NY)
- Deputy Director Enterprise Asset Management Value Realization Job ID: 6664 Business Unit: MTA Headquarters Location: New York, NY, United States ... - $175,000 HAY POINTS : 1096 DEPT/DIV: Strategic Initiatives \ Enterprise Asset Management SUPERVISOR : Director , Enterprise Asset Management LOCATION :… more
- Evolent (Albany, NY)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Humana (Albany, NY)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer based review of...size of region or line of business. The Medical Director conducts Utilization Management of… more