- Sharecare (Albany, NY)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- MVP Health Care (Tarrytown, NY)
- …Master's prepared and licensed mental health clinician (LMSW, LCSW, LMHC, etc.) or Licensed Registered Nurse ( RN ) required + New York State license required ... with at least 2 years being ASD related + Utilization or Case Management experience in a...our customers in every interaction **Your key responsibilities:** + Review all requests for behavioral health services utilizing the… more
- BronxCare Health System (Bronx, NY)
- …response by the department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal ... the department's leadership develop strategies for denial prevention, improved utilization management, documentation of medical necessity and identify patterns and… more
- CenterLight Health System (Ridgewood, NY)
- …in care/ case management, disease management, population health management, utilization review , quality assurance, or discharge planning (preferably within ... management systems License: Current active and unrestricted license in NYS as a Registered Nurse , required. Additional Requirements: + Be legally authorized (for… more
- Highmark Health (Albany, NY)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. ... **EXPERIENCE** **Required** + 7 years in any combination of clinical, case / utilization management and/or disease/condition management experience, or provider… more
- WMCHealth (Valhalla, NY)
- …the results. + Maintains familiarity with the laws, regulations, and interpretation of utilization review and discharge planning. Remains up to date on changes ... 2. Identify opportunities to improve reimbursement. 3. Provide direction to the Case Management staff in relation to denials/appeals which includes training and… more
- Northwell Health (Mount Kisco, NY)
- …Job Description Directs, plans, implements and evaluates all activities of the inpatient RN Case Management and Social Work Services team. Develops processes to ... monitor utilization review inclusive of length of stay...safe discharge back to the community. Job Responsibility 1.Leads RN case management and social work services… more
- Kaleida Health (Buffalo, NY)
- …of experience in any combination of case management, home care and utilization review preferred. Knowledge of and experience with Interquel Criteria set and ... Basic Life Support (BLS) required upon hire. Current NYS registration as a Registered Professional Nurse / RN Permit and American Heart Association-Basic Life… more
- Garnet Health (Harris, NY)
- … Manager for the detox patient on the medical floor assuring discharge planning, utilization review , and insurance approval. At Garnet Health, we are committed ... organize/prioritize accordingly, and implement evidence based care. Social Work Clinician/ Case Manager - primary role is to provide psychiatric/detox emergency… more
- Elevance Health (Middletown, NY)
- …services only, and there is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with ... and outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses appropriate screening… more