- 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...acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical,… more
- Guthrie (Corning, NY)
- …Has an understanding of the regulatory requirements relative to the case management process. Certified to complete Patient Review Instruments (PRIs). Has ... and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates… more
- Mount Sinai Health System (New York, NY)
- …preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... **Job Description** The Case Manager (CM) will be responsible for all aspects...new admissions to identify patients where utilization review , discharge planning, and/or case management will… more
- Northwell Health (Staten Island, NY)
- …care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness ... management and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge planning, preferred. +… more
- Ellis Medicine (Schenectady, NY)
- …provided by the Case Manager include, but are not limited to, utilization review , case management , care transition, collaboration with physicians and ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for case management ...experience in a hospital environment preferred. + Previous case management , utilization review , and discharge… more
- L3Harris (Rochester, NY)
- …hiring, firing, promotion and compensation authority within own organization, in accordance with management review and approval. + Work requires a high degree of ... and cyber domains in the interest of national security. Job Title: Sr Manager , Operations Managment Job Code: 26621 Job Location: Rochester, New York Job Schedule:… more
- Molina Healthcare (Yonkers, NY)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years… more
- Arnot Health (Elmira, NY)
- …Bachelor's in nursing preferred. Must have proficient writing skills.Experience in Utilization Review and InterQual required. CARDIOPULMONARY RESUSCITATION (CPR) ... Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal...FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and retrospective… more
- TD Bank (New York, NY)
- …for this role. **Line of Business:** Audit **Job Description:** The Audit Manager is accountable for overseeing the planning and execution for audits covering ... + Performs testing of critical areas of audit. Performs review of audit documentation. Oversees findings follow up and...subject matter expertise. + Acts as primary contact with management regarding audit scope, findings and status **Education &… more
- Healthfirst (NY)
- The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review , discharge ... planning, and case management as assigned. The Case Manager , Utilization Management is also responsible for efficient utilization of health services… more