- Elmcrest Children's Center (Syracuse, NY)
- …+ Work cooperatively with the Supervisor, Medicaid Managed Care Liaisons, and potential Care Manager , on each case to maintain the best quality of ... and communicate with team when there are changes. + Completion of Managed care contact notes (progress notes) + Attending supervision and staff meetings as… more
- Molina Healthcare (Yonkers, NY)
- …(CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America ... new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified… more
- Mount Sinai Health System (New York, NY)
- …day-to-day operations, in collaboration with the School Based Health Center Administrative Practice Manager , in the care and treatment of patients as delineated ... Center ("MSAHC" or the "Center") works to provide health care and wellness for young people by providing vital...charged with ensuring that the above functions are developed, managed and delivered within a culture that is youth-centric,… more
- Mount Sinai Health System (New York, NY)
- …pharmacy group. 11.Obtains prior authorizations from intermediaries and payers, including managed care companies, insurance companies or others as appropriate. ... direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager and the Specialty Pharmacy Clinical Liaison, the Specialty Pharmacy Access… more
- Molina Healthcare (Albany, NY)
- …experience, and at least 2 years as a medical director in managed care setting supporting utilization management/quality management initiatives, or equivalent ... to members - ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching...(CPHM), Certified Professional in Healthcare Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case … more
- CVS Health (Albany, NY)
- …actionable opportunities related to CM, gap closure, workflow discussions, and partnering with case manager supervisor/ manager and CMs - Serving as internal ... in state the candidate resides - 4+ years of case management experience - 3+ years clinical experience -...while working in a matrixed environment. - 1+ year managed care experience - Creating accountability, developing… more
- Elevance Health (Latham, NY)
- …a minimum of associate's degree in nursing. + Requires a minimum of 4 years managed care experience and requires a minimum of 2 years clinical, utilization ... not be receiving appropriate type, level, or quality of care , eg, if services are not in line with...skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has… more
- New York State Civil Service (NY)
- …all Willowbrook training requirements. * Follow up on hospitalizations and ensure that the care manager is coordinating and planning for discharge. * Ensure that ... appropriate placement. * Monitor the timely completion of Quarterly Case load reports from CCO's and the monthly Nursing...the request of the RFO/DDSOO, CAB, class member/advocate or Care Manager regarding concerns with class members.*… more
- Molina Healthcare (Syracuse, NY)
- …(CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America ... new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …and Off Marketplace health insurance products, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC), Essential Plan (EP) and the Individual Market - ... through home visits and outreach. * Educates and assists members with accessing care , Case Management program and benefits and government cell phone programs.… more