- Arms Acres (Carmel, NY)
- …enhance the services we provide. The UR Coordinator assists in the overall utilization management process to ensure that services and programs meet accepted ... eligible and/or have at least three years' experience in case management , utilization management or chemical dependency. PHYSICAL DEMANDS: The physical… more
- Calvary Hospital (Bronx, NY)
- …unencumbered NYS licensure. + Five (5) or more years experience in either Utilization Management , Quality Assessment and Improvement, Risk Management , and/or ... Spending, Transit Check. + Free On-Site Parking Requirements Participates in the Utilization Review, Discharge Planning, Risk Management , and Quality Assessment… more
- Stony Brook University (Stony Brook, NY)
- …telephonically post-discharge and assist with barriers to care * Prior experience with Care Management or Utilization Management * Understand levels of care ... is provided to the patients. * Documents the case management plans such as clinical needs, barriers, utilization... management plans such as clinical needs, barriers, utilization of resources via assessments and/or progress notes. *… more
- CenterWell (Albany, NY)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... in a high volume and fast paced environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a related field + Health… more
- Nuvance Health (Rhinebeck, NY)
- …case from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within ... of the Director, The Nurse Case Manager role provide clinically-based case management to support the delivery of effective and efficient patient care. Paces… more
- Molina Healthcare (Rochester, NY)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... proficient, self-directed, autonomous and experience working from home. Care Management & Waiver Service Auditing experience is highly preferred. Work… more
- Centene Corporation (Queens, NY)
- …of managed care or medical group experience, provider relations, quality improvement, utilization management , or clinical operations. Project management ... care to our members. Participate in the development of network management strategies. Creates strategic initiatives for performance improvement. + Conducts regular… more
- Catholic Health Services (Smithtown, NY)
- …patients across the acute care continuum. + Performs required activities for utilization management , PRI assessment and completion, transition planning, and ... clinical medical/surgical or specialty experience required. + 2-3 years' Utilization Management , Performance Improvement, Transition Planning and/or Care… more
- Evolent (Albany, NY)
- …billing and various sites of care/service + Familiarity with value-based care and utilization management + Understanding of data systems and the critical ... member-centric products. This role plays a critical part in both **Medical Cost Management ** and **Product Management ** , leveraging advanced analytics to solve… more
- Evolent (Albany, NY)
- …Oncology is a key clinical executive responsible for leading oncology-related utilization management , quality improvement, and clinical operations across ... cost of oncology care + Lead the development of strategies for care management , utilization mitigation, and value-based incentive programs **Desired Skill Set**… more
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