- Guthrie (Binghamton, NY)
- …for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with other internal ... years of experience in an acute care setting with strong care management, utilization review, and payer knowledge. A Case Management certification or obtaining a… more
- Molina Healthcare (Syracuse, NY)
- …oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical ... working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
- Publicis Groupe (New York, NY)
- …outcomes. The Director monitors key performance metrics such as utilization , billability, and capacity planning while addressing complex resourcing challenges ... updates clearly and frequently to agency teams. + Manage staff utilization by monitoring project activities, identifying under/over- utilization , and addressing… more
- Molina Healthcare (NY)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2 ... emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge...managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.… 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
- Evolent (Albany, NY)
- …As a Field Medical Director, Oncology, 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
- SUNY Upstate Medical University (Syracuse, NY)
- …and community-based partners to develop strategies to decrease unnecessary hospital ED utilization . In this position, the social worker will Identify utilization ... knowledge of social determinants, population health and drivers of utilization . Duties will include consultation through assessment, counseling, intervention,… 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
- Mount Sinai Health System (New York, NY)
- …on reducing the length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice and may require ... Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or… more
- Evolent (Albany, NY)
- …Doing:** Job Description 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