- Rochester Regional Health (Rochester, NY)
- …3 years acute hospital care experience not required. PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience preferred. + Bachelor's ... Job Title: Care Facilitator Department: Case Management Location: Canton-Potsdam Hospital with floating to...in the expected time frame and with most efficient utilization of resources. Carries out activities related to … more
- Elevance Health (Latham, NY)
- …information regarding case and determines appropriate area to refer or assign case ( utilization management, case management, QI, Med Review). + Provides ... and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information.… more
- Global Foundries (Malta, NY)
- …that Workday will automatically populate in every external job description. The Hiring Manager only needs to provide the above pieces of information. If you need ... and your contact information. Requests for accommodation will be considered on a case -by- case basis. Please note that only inquiries concerning a request for… more
- Global Foundries (Malta, NY)
- …that Workday will automatically populate in every external job description. The Hiring Manager only needs to provide the above pieces of information. If you need ... and your contact information. Requests for accommodation will be considered on a case -by- case basis. Please note that only inquiries concerning a request for… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Specialist provides administrative support for any of the programs of Utilization Management, Behavioral Health, Quality Management, or Member Care Management. This ... Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates and utilizes corporate...assigned to non-care managers are monitored by the care manager + The care manager provides feedback… more
- Elevance Health (Latham, NY)
- …4 years managed care experience and requires a minimum of 2 years clinical, utilization review, or case management experience; or any combination of education ... thinking skills and nursing judgment and experience. + Collaborates with case management nurses on discharge planning, ensuring patient has appropriate equipment,… more
- Kaleida Health (Buffalo, NY)
- …degree in Nursing required within five (5) years of hire to the position. Certified Case Manager (CCM) preferred. Employees in the job title prior to 3/29/10 are ... required. 2 years of experience in any combination of case management, home care and utilization review...combination of case management, home care and utilization review preferred. Knowledge of and experience with Interquel… more
- Elevance Health (New York, NY)
- …Coordinator - RN Clinician** is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to non-RN ... clinicians participating in the member's case in accordance with applicable state law and contract;...co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a thorough and… more
- Bassett Healthcare (Cooperstown, NY)
- …providers to coordinate treatment plan goals and objectives . Participates in case conference treatment team meetings . Treats patients, colleagues, and other staff ... of practice in the field . Participates in the Utilization Review Process . Collaborates with outside agencies, such...other duties as requested and observed by supervisor or manager . Partial remote work is available dependent upon… more
- Molina Healthcare (Buffalo, NY)
- …Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), ... medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * Identifies… more