- Arnot Health (Elmira, NY)
- …related to the management of patient care . The Case Manager will review all patients for utilization management and appropriate discharge planning. The ... The Case Manager tracks and trends LOS , resource utilization , outliers, readmissions , denials , delay days...with a current license as a registered nurse . BSN or Case Management Certification… more
- Stony Brook University (Stony Brook, NY)
- …telephonically post-discharge and assist with barriers to care * Prior experience with Care Management or Utilization Management * Understand levels of care ... may be at a high risk for readmission. The RN following these patients must have good clinical and...is provided to the patients. * Documents the case management plans such as clinical needs, barriers, utilization… more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... 40 hours per week Respiratory Therapist (RT) / Respiratory Nurse ( RN ) We are searching for a...facility's Employee Handbook and as communicated by the facility's management . . Contributing to a positive work team by… more
- Highmark Health (Albany, NY)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- Healthfirst (NY)
- …oversight and operational management for all utilization management functions, including prior authorization, concurrent review , and service requests ... efforts for audits, performance improvement plans, and corrective actions related to utilization management + Foster a culture of accountability, professional… more
- Kaleida Health (Williamsville, NY)
- …plans/care paths are addressed and met. Serve as liaison to ancillary and utilization review services, serve as communication link between health team members. ... discharge planning, case management and home care required. Knowledge of Utilization Management . Use of computer applications related to health care industry… more
- Mohawk Valley Health System (Utica, NY)
- …- Days Department: QUALITY IMPROVEMENT Job Summary The Quality Professional is a Registered Nurse with clinical experience in Med/Surg, Critical Care and other ... of disease and patient management . Preferred: + Knowledge of Quality Management , Performance Improvement and Utilization Management requirements and… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... RN Supervisor Case Management - Full...Performs related duties as assigned. Education/Experience Requirements REQUIRED: + Registered Nurse licensed in State of New… more
- Mohawk Valley Health System (Utica, NY)
- …regulatory compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review /case management experience or social work ... RN - Case Manager - Full Time -...Reports to and is under direct supervision of Case Management Department. Provides ongoing support and expertise through comprehensive… more
- Mount Sinai Health System (New York, NY)
- …to: a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using standardized ... **Job Description** ** RN /Case Manager MSH Case Management PT...Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or… more