- Centene Corporation (New York, NY)
- …taken on member medical records in health management systems according to utilization management policies and guidelines + Works with healthcare providers to approve ... and concurrent review findings + Assists with providing education to providers on utilization processes to ensure high quality appropriate care to members + Provides… more
- Veterans Affairs, Veterans Health Administration (Montrose, NY)
- …for budget management, determining and allocating resources, ensuring proper utilization in productivity, efficiency, and cost effectiveness of the operation. ... budget management, determining resource needs, allocating resources, ensuring proper utilization in productivity, efficiency, and cost effectiveness of the… more
- CVS Health (Albany, NY)
- …insights and consultative solutions tailored to client needs. * Analyze utilization and performance data to inform recommendations and interventions. * Coordinate ... proficiency) * Financial acumen, including understanding of pricing and utilization metrics * Collaborative mindset with experience working across functions… more
- Mount Sinai Health System (New York, NY)
- …of 340B program compliance, hospital pharmacy operations, and medication utilization . + Demonstrated ability to manage complex projects, prioritize tasks, ... interactive dashboards and reporting tools to monitor pharmacy expense trends, utilization , and key performance indicators. + Manage and maintain Pharmacy DataMart… more
- Mount Sinai Health System (New York, NY)
- …by: 1) Assisting clinical nurses and other health care professionals in the utilization of the nursing problem solving process in current clinical situations. 2) ... clinical nurses and other health care professionals in the utilization of the nursing problem solving process in current...research in clinical practice. i. Participates in development and utilization of nursing research designs and serves as a… 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 post ... insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization, such… more
- Cree (Marcy, NY)
- …alignment and progress in industrial engineering projects. Analyzes work force utilization , work center layout, material flows, production costs, process flow and ... production requirements to determine the most efficient utilization of personnel and equipment. This Job is Right for You if You Have (Minimum Requirements): BS… more
- Nuvance Health (Poughkeepsie, NY)
- …from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within the assigned ... and collaborates with other health care team members to identify appropriate utilization of resources and to ensure reimbursement. Utilizes criteria to confirm… more
- Catholic Health Services (West Islip, NY)
- …collaboratively with, but not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals, Managed Care and Revenue Cycle and Patient ... Hospital Conditions of Participation. Implements care management programs, including utilization review, intake and discharge planning. Evaluates patient care data… more
- Molina Healthcare (Buffalo, NY)
- …key medical management initiatives and analytical studies aimed at optimizing utilization of medical resources and maximizing operational efficiencies. + Engages ... with contracting/ network to standardize contracts for quality and utilization . **Job Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree in Healthcare,… more