- Helio Health Inc. (Syracuse, NY)
- …efforts to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ... position and also take into account information provided by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case /Care Management Position… more
- Ellis Medicine (Schenectady, NY)
- …to Medicare beneficiaries per CMS Conditions of Participation at the direction of the Case Manager . * Utilization Management Activities; Collaborates with ... Activities; Contacts referral agencies to make post discharge arrangements for patients. Assists Case Manager or Social Worker by offering choice of providers.… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/ Case Manager MSH Case ... utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... are not limited to: a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using… more
- Molina Healthcare (Buffalo, NY)
- …Active, unrestricted State RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), ... or state board licensing mandate. + At least 2 years in case , disease or utilization management; managed care; or medical/behavioral health settings. + One year… more
- Guthrie (Binghamton, NY)
- …clinical approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the ... On Bonus For Qualified RNs! Position Summary: The Acute Case Manager utilizes industry accepted processes for...in an acute care setting with strong care management, utilization review, and payer knowledge. A Case … more
- Ellis Medicine (Schenectady, NY)
- …The Discharge Planner's primary function is to work with the Social Worker, Nurse Case Manager , or Utilization Management Nurse to facilitate patient ... beneficiaries per CMS Conditions of Participation at the direction of the Case Manager . + Utilization Management Activities: + Collaborates with Case… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as required,… more
- Bassett Healthcare (Cooperstown, NY)
- …health and enjoy the best quality of life possible. What you'll do The Case Manager RN supports the physician and interdisciplinary team in facilitating patient ... management, care facilitation, and discharge planning functions. The Case Manager is accountable for a designated...in both areas. + Refers cases and issues to Case Review, Utilization Committee, Medical Director, and… more
- Molina Healthcare (Yonkers, NY)
- …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... and quality initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and cost control issues… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
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