- Molina Healthcare (Buffalo, NY)
- …state regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Assesses appropriateness of services , length of ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal...individual judgment and experience to assess the appropriateness of service provided, length of stay and level of care.… more
- CenterWell (Albany, NY)
- …of the largest providers of home health services , and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... community and help us put health first** The Senior Product Owner - Clinical Referral and Specialty Care is responsible for conveying product vision and roadmap… more
- Crouse Hospital (Syracuse, NY)
- …education and outreach programs. Crouse's Surgical Suite/Operating Room is hiring a Clinical Supervisor to oversee service delivery and patient procedures. Pay ... Health Employee Assistance Program. + Employee discounts on any Inpatient or Outpatient service , hospital cafeteria and pharmacy , and certain retailers. + YMCA… more
- InGenesis (New York, NY)
- InGenesis is currently sourcing for a Contract Services Manager (CM) to join our team. As the onsite point of contact for the medical personnel for the staffing ... contract with IHSC (Immigration Health Services Corps), you will play a critical role in...strategic, data-driven solutions that include redefining workforce management and clinical service delivery. Explore InGenesis to discover… more
- CenterWell (Hauppauge, NY)
- …of the largest providers of home health services , and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... and case managers within an assigned territory to promote our home care services . . Build and maintain client relationships. . Prepare business plans and maintain… more
- Albany Medical Center (Albany, NY)
- …Step-down Unit, Emergency Department, and Post-Anesthesia Care Unit. Our service population includes: Trauma, Orthopedics, ENT, Thoracic, Plastics, and Bariatric ... * Engaged Leadership team that consists of a nurse manager , assistant nurse manager and a nurse...Coordinators 3. Rapid Response / Code Blue Team 4. Clinical Support/ PICC Team 5. Wound Ostomy Team 6.… more
- CVS Health (Albany, NY)
- …as well as additional off-phone and administrative operations critical to specialty pharmacy services . This leader will ensure all pre-shipment issues are ... do it all with heart, each and every day. **Position Summary** The Specialty Pharmacy Off-Phone Audit Manager leads the internal audit function for CVS… more
- CenterWell (Corning, NY)
- …of the largest providers of home health services , and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... each patient, provide necessary follow-up as directed by the Clinical Manager . + Confer with physician in...identity or religion. We also provide free language interpreter services . See our full accessibility rights information and language… more
- CDPHP (Latham, NY)
- …corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality ... or external referral sources. Applies case management criteria and professional clinical judgment to determine a member's appropriateness for case management … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality ... drivers. Essential Accountabilities: Level I + Handles physical health member clinical management programs. + Maintains knowledge of current Case Management Society… more