- Rochester Regional Health (Rochester, NY)
- …navigation for patients, including triage management, algorithm management, utilization management and resource management. Organizes services across the ... as possible after admission-within the first 12 to 24 hours. Applies utilization review criteria to assess and document appropriateness of admission, continued stay… more
- Hillside Family of Agencies (Rochester, NY)
- …operations of the program, including hiring, training, fiscal management, utilization management, clinical oversight and regulatory compliance. ESSENTIAL JOB ... within budget parameters. + Ensures program consistently achieves budgeted utilization and works with team to address any ...utilization and works with team to address any utilization barriers. + Youth ACT and Therapeutic Foster Care… more
- Kaleida Health (Buffalo, NY)
- …tactics to successfully execute, support, implement, and monitor the DRG and Utilization Management Clinical Denial teams Work Plan and, assists in the development ... skills including Microsoft word, Microsoft excel with spreadsheet development and utilization , Microsoft outlook required. 8 years of experience in multi- hospital… more
- City of New York (New York, NY)
- …leveraging DDC's procurement contracts to advance DDC's and citywide M/WBE utilization goals; reviewing and approving subcontractors and subcontractor utilization ... supporting the development and implementation of the agency's annual M/WBE Utilization Plan; and completing project closeout functions to assess final compliance… more
- Guthrie (Binghamton, NY)
- …years of experience in an acute care setting with strong care management, utilization review, and payer knowledge. A Case Management certification or obtain a Case ... the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates the physician and other… more
- Abbott (Hauppauge, NY)
- …includes influencing stakeholders within the hospital, driving product utilization , support on contracting, relationship development, relationship management, market ... territories. + Influence stakeholders within the hospital setting. + Drive product utilization in key growth categories and driving sales/placement of capital to… more
- Humana (Albany, NY)
- …with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or ... insurance, other healthcare providers, clinical group practice management + Utilization management experience in a medical management review organization, such… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …management rounds. + Provision of clinical oversight and leadership to Utilization Management/Case Management (UM/CM) staff working with the children's population. + ... interpretation. + Develops and implements the BH sections of the Quality Management/ Utilization Management (QM/UM) Plan, including having the BH Medical Director for… more
- CVS Health (Albany, NY)
- …outreach priorities based on service territory and capacity constraints + System Utilization & Workflow Management + Operate and maintain Salesforce Field Service to ... and dashboards to monitor key performance metrics, such as provider utilization , appointment adherence, and member outreach conversion + Operational Communication &… more
- New York State Civil Service (Albany, NY)
- …after the EHR go-live, troubleshooting issues and offering guidance on system utilization . * Facilitate workshops and presentations to educate stakeholders about the ... recommending optimization strategies. * Analyze data trends related to EHR utilization , clinical outcomes, and compliance within mental health programs, providing… more