- CDPHP (Latham, NY)
- …with Medicaid Long Term Care Programs preferred. + Minimum of two (2) years Utilization Management experience is preferred. + Experience with the New York State ... coordinating the care of CDPHP members who meet case management criteria across the continuum of care, ensuring and...serviced by CDPHP. Based on national standards for case management practice, the RN Case Manager will focus on… more
- Molina Healthcare (Yonkers, NY)
- …at least 3 or more years in one or more of the following areas: utilization management , care management , care transitions, behavioral health, or equivalent ... work of external vendors. * Focuses on process improvement, organizational change management , program management and other processes relative to business needs.… more
- CVS Health (Albany, NY)
- …may include operations, sales, marketing, provider relations, network development, utilization management , and/or STARS/HEDIS quality improvement, and Revenue ... CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their path to better health and… 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
- MVP Health Care (Schenectady, NY)
- …with children and/or adolescents, with at least 2 years being ASD related + Utilization or Case Management experience in a managed care organization is preferred ... meet established deadlines. + Ability to make independent decisions regarding resource utilization , and quality of care. + Must demonstrate understanding of clinical… more
- Northwell Health (Sleepy Hollow, 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
- Molina Healthcare (Cheektowaga, 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
- Northwell Health (Poughkeepsie, 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
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …drivers and budgets, formulary access management , coverage decision processes and utilization management . - Experience with pre-launch drugs and new product ... strategies, customer interactions, sales team performance, lead generation, pipeline management , pull through tactics and execution, and sales analytics for… more
- NBC Universal (New York, NY)
- …organization, to ensure best in class capability. + Manage and refine the utilization of resilience-enabling management systems, ie Fusion Risk Management ... to enabling our core business objectives. The Sr. Manager, Crisis Management /Business Continuity role requires an experienced practitioner well-versed in risk,… more
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