- University of Rochester (Brighton, NY)
- …results received and acted upon as needed + Document plan of care, patient utilization , care management activities and other required information in state and ... and internal equity considerations._ **Responsibilities:** Provides professional comprehensive care management services to patients of the Strong Memorial Hospital,… more
- Albany Medical Center (Albany, NY)
- …hospital clinical leadership, legal, compliance, billing, finance, IT, case and utilization management , quality, credentialing, and other related departments. ... the high level, multifaceted competencies needed for the implementation and management of payer contracting strategies including building solid external payer… more
- CVS Health (Albany, NY)
- …experience in health care delivery (clinical practice) Experience in managed care, care management , utilization management , quality management , or ... products and programs as well as sales and account management . Duties include support for - case management... management . Duties include support for - case management , clinical content research & development, chronic condition … more
- Molina Healthcare (Buffalo, NY)
- …including 3 or more years in one or more of the following areas: utilization management , case management , care transition and/or disease management ... work of external vendors. + Focuses on process improvement, organizational change management , program management and other processes relative to the business.… more
- Trinity Health (Albany, NY)
- …experience in acute setting **Preferred requirements:** + 1+ year of experience in case management or utilization management + Case Management ... Engage the patient and care team in the joint management of key patient outcomes such as management of disease progression, continued LOS and transition to most… more
- Travelers Insurance Company (Albany, NY)
- …skills **What is a Must Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board of Medical Specialties ... to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon as medically… more
- OLV Human Services (Lackawanna, NY)
- …are maximized + Monitor key performance indicators (KPIs), including census/unit utilization , denial management , days in accounts receivable, benchmark/trends, ... rate methodologies, healthcare, mental health and dental billing + Analyze census/unit utilization to ensure programs properly maximize revenue + Oversee and manage… more
- Northwell Health (Manhasset, NY)
- …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + ... Submits data to management regarding case management and/or quality initiatives. + Serves as an in-patient liaison - planning, assessing, implementing and… more
- University of Rochester (Rochester, NY)
- …such as Medicaid Enrollment & Outreach, Financial Assistance, Registration and Insurance Management , Utilization Management , Social Work, Patient Accounts, ... education and experience REQUIRED. **KNOWLEDGE, SKILLS & ABILITIES** + Experience in management , operations, and leadership PREFERRED. + Requires a high degree of… more
- Molina Healthcare (NY)
- …example, such meetings would occur to discuss and resolve issues related to utilization management , pharmacy, quality of care, and correct coding. * ... and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability… more