- Molina Healthcare (NY)
- … (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy ... **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services/ Management staff work to ensure that Molina members...initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and… more
- Elevance Health (Latham, NY)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... accommodation is granted as required by law._ " The ** Utilization Management Representative II** is responsible for...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Latham, NY)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... integration, and ensures essential face-to-face onboarding and skill development. The ** Utilization Management Representative I** will be responsible for… 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 management for an ... utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...a Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management … more
- Guthrie (Binghamton, NY)
- …five (5) years of experience in an acute care setting with strong care management , utilization review, and payer knowledge. A Case Management certification ... Position Summary: The Acute Case Manager utilizes industry accepted processes for achieving optimal...members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria.… more
- Crouse Hospital (Syracuse, NY)
- …day management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... outreach programs. Crouse's Care Coordination team is hiring a Manager who is responsible for providing day to day... who is responsible for providing day to day management of the RN Care Managers in the department.… more
- Guthrie (Corning, NY)
- …and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates ... Summary: In collaboration with the interdisciplinary healthcare team, the Case Manager will coordinate the flow of services throughout the patient's hospitalization… more
- Capital One (New York, NY)
- Manager , Product Management - AI/ML Platform Foundations Product Management at Capital One is a booming, vibrant craft that requires reimagining the status ... upon number of hours to be regularly worked. Cambridge, MA: $158,400 - $180,800 for Manager , Product Management Chicago, IL: $144,000 - $164,400 for Manager ,… more
- Northwell Health (Staten Island, NY)
- …another level of care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for ... management and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge planning, preferred. + Keeps… more
- Mount Sinai Health System (New York, NY)
- …ongoing improvement, and roadmap for the Oracle Cloud applications. The Product Manager will oversee project management and end-user training activities to ... **Job Description** **Oracle Cloud Product Manager II - Digital and Technology Partners -...Managers work with cross-functional teams to: + Provide project management and training leadership to define the strategic direction… more