- Spectrum Health and Human Services (Buffalo, NY)
- …Care Coordinator will be responsible for the following outcomes: to reduce utilization associated with avoidable and preventable inpatient stays, to reduce ... utilization associated with avoidable emergency room visits, to improve...+ Collaborate/coordinate with community base providers to support effective utilization of services based on client/family need. + Maintains… 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
- Molina Healthcare (Yonkers, NY)
- …and Finance team through analyzing key business issues related to cost, utilization and revenue for multiple Molina Healthcare products. Designs and develops reports ... and/or Tableau and data management + Knowledge of healthcare operations ( utilization management, disease management, HEDIS quality measures, claims processing, etc.)… more
- Evolent (Albany, NY)
- …+ Leading a team in the analysis and interpretation of cost and utilization data (medical and pharmaceutical) to explain potential upside/downside risks of a given ... Previous experience in a medical economics related position within Utilization Management/Clinical Vendor Management functions + Knowledge of healthcare underwriting… more
- Compass Group, North America (New York, NY)
- …to achieve a consistently outstanding level of quality through the effective utilization of available facilities and services as well sets service excellence ... booking of space within the Reservation System, so as to ensure maximum utilization of the facilities by the client organization. + Developing and constantly… more
- Mohawk Valley Health System (Utica, NY)
- …responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include the supervision ... Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member care needs… more
- Hillside Family of Agencies (Rochester, NY)
- …effectively to meet agency and regulatory requirements. + Facilitate Agency Utilization Management meetings to ensure residential youth continue to be placed ... recommendations. + Collect, aggregate, and analyze data to identify unmet needs, utilization trends, and opportunities for improvement of existing services as well… more
- Rochester Regional Health (Rochester, NY)
- …and community resources. + Promote timely access to appropriate care. + Increase utilization of preventative care. + Reduce emergency room utilization and ... + Defines and directs patients and/or families to appropriate resource utilization . + Increase patients' ability for self-management and shared decision-making. +… more
- Catholic Health Services (Melville, NY)
- …Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical documentation. ... Advisors during the monthly Physician Advisor meeting. Attends hospital Utilization Management (UM) committees. Supervises the Facility Physician Advisors. Observes… more
- Ellis Medicine (Schenectady, NY)
- …implement and evaluate individual healthcare needs. Integrate Discharge Planning, Utilization Review and Performance Improvement activities at the patient, hospital ... levels. Efficiently and effectively anticipates, identifies and resolves issues through utilization review and discharge planning processes. Collaborates with the ED… more