- Northwell Health (Staten Island, 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
- BronxCare Health System (Bronx, NY)
- …assist the department's leadership develop strategies for denial prevention, improved utilization management , documentation of medical necessity and identify ... all telephone communications in accordance with department procedures using Care Management and other resources, escalates issues related to business associate… more
- Molina Healthcare (Buffalo, 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
- MVP Health Care (Tarrytown, NY)
- …every interaction **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes ... as a Registered Nurse required. + Certification in Case Management required within 24 months after hire. + At...At least 3 years of recent clinical and Case Management experience. Experience working in a Medicaid Long Term… more
- Albany Medical Center (Albany, NY)
- …members, and friends to advocate for our patients' needs. + Collaborate with Risk Management , Patient Relations, Utilization Management , Case Management , ... Department/Unit: Care Management /Social Work Work Shift: Day (United States of America) Salary Range: $71,612.39 - $110,999.20 The SNUG social worker provides… more
- Highland Hospital (Rochester, NY)
- …planning to achieve timely and safe discharge and/or to coordinate access and utilization management , proactive patient management , care facilitation and ... nursing experience. Progressive clinical experience including community health, care management , and/or disease management is preferred. 2. Experience… more
- Robert Half Finance & Accounting (Lackawanna, NY)
- …contracts * 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
- CVS Health (Albany, NY)
- …Delivery System eg, Clinical Practice and Health Care Industry. *Prior UM ( Utilization Management ) experience *Active and current state medical license without ... provide oversight for medical policy implementation. You will support the Medical Management staff ensuring timely and consistent responses to members and providers.… more
- Samaritan Daytop Village (Queens, NY)
- …program employees and agency administration. The Program Director will be responsible for census/ utilization management and quality assurance. What You Will Do + ... Role The Program Director is responsible for the overall clinical and budget management and administrative operations of his/her assigned program(s). He or she is… more
- Wolters Kluwer (Albany, NY)
- …including: + Conducting regular account review meetings and reviewing account utilization management reporting to provide recommendations + Overseeing contract ... + Closely managing the deal through closure and keeping management informed of any risks or delays + Retaining...level and other key decision makers + Excellent account management skills and ability to manage external and internal… more