- Molina Healthcare (Buffalo, NY)
- …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), case ... Collates and reports on Care Access and Monitoring statistics including plan utilization , staff productivity, cost effective utilization of services, management… more
- Evolent (Albany, NY)
- …You'll Be Doing:** As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization … more
- Molina Healthcare (Buffalo, NY)
- …multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** * At least 2 ... experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. **Preferred… more
- Evolent (Albany, NY)
- …Clinical Reviewer, Interventional Pain Management, you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization … more
- Molina Healthcare (Syracuse, NY)
- …authorization requests as needed. * Researches, develops, and implements drug utilization and disease state management strategies and intervention techniques to ... Pharmacy Benefit Manager (PBM) reports to track general trends in drug utilization and identify potential targeted utilization management activities. * Works… more
- Molina Healthcare (NY)
- …healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare ... utilization and cost containment reports and makes recommendations based...and statistical models to predict future trends in cost, utilization , and performance. Guide team members on appropriate writing… more
- Molina Healthcare (Albany, NY)
- …healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare ... utilization and cost containment reports and makes recommendations based...weekly/monthly/quarterly/annually standard reports. + Must have experience in analyzing Utilization management, member health risk assessment data using SQL,… more
- Northwell Health (Mount Kisco, NY)
- …Case Management and Social Work Services team. Develops processes to monitor utilization review inclusive of length of stay (LOS) and resource reduction strategies, ... facility best practices and makes recommendations for process improvement. Oversees resource utilization for the hospital and provides specific data analysis on … more
- NYS Housing Trust Fund Corporation (New York, NY)
- …of receivables, tax reporting, and the management of program funding and voucher utilization . HCR seeks a qualified financial analyst to report to the program Chief ... candidates will assist in reporting on funding and voucher utilization , establishing program payment standards and utility allowances, performing year-end… more
- Evolent (Albany, NY)
- …Medical Director, Physical Medicine and Rehab you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization … more