- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of clinical… more
- Catholic Health Services (Melville, NY)
- …was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate ... utilization management and appeals functions to include coordination of...related activities. Position Responsibilities: + Prepares necessary documentation for utilization management and appeals processes, performs data management and… more
- Crouse Hospital (Syracuse, NY)
- …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage data and client ... care as it relates to the utilization of services. Pay Range: $80,000.00 / year + Utilization Management RNs are eligible for up to a $10,000 Sign-On Bonus!… more
- Humana (Albany, NY)
- …of our caring community and help us put health first** The Manager, Utilization Management Nursing (LTSS Utilization Management Leader) utilizes clinical nursing ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines and procedures;… more
- Molina Healthcare (Syracuse, NY)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The **Senior Analyst, Utilization Management** plays a critical role in supporting clinical and operational ... needs into technical solutions. This role works closely with clinicians, utilization management teams, and business stakeholders to gather requirements and deliver… more
- Helio Health Inc. (Syracuse, NY)
- …review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ourSyracuse ... appropriate. + Assist in developing and administering policies and procedures for utilization . + Negotiating access to care for individuals seeking services at Helio… more
- CVS Health (Albany, NY)
- …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with productivity and… more
- New York State Civil Service (New York, NY)
- NY HELP No Agency Empire State Development, NYS Title Project Manager, Utilization - MWBE Occupational Category Other Professional Careers Salary Grade NS Bargaining ... direct supervision of the Director of Contract Participation, the Project Manager, Utilization , will lead the planning, execution, and monitoring of key initiatives… more
- Trinity Health (Albany, NY)
- …these differences often lead to innovative solutions. **Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme Days** If you ... shifts to accommodate all schedules **What you will do:** + Perform utilization management, both concurrent and retroactive for inpatient and outpatient services in… more
- Humana (Albany, NY)
- …of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently… more
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