- Highland Hospital (Rochester, NY)
- …the OB RN Care Manager's central role integrates and coordinates access and utilization management , proactive patient management , care facilitation and ... nursing experience preferred. Progressive clinical experience; community health, care management , and/or disease management is preferred. Experience working… more
- Albany Medical Center (Albany, NY)
- …and evaluation of services to patients and families + Collaborate with Risk Management , Patient Relations, Utilization Management , and Quality Management ... Department/Unit: Care Management /Social Work Work Shift: Day (United States of America) Salary Range: $65,102.17 - $100,908.37 Medical Social Worker Create optimal… more
- Evolent (Albany, NY)
- …+ Strong understanding of healthcare market dynamics, payer/provider relationships, and utilization management . + Familiarity with tools like Excel, PowerPoint, ... growth, retention, and client satisfaction. **Key Responsibilities** **Collaboration & Relationship Management ** + Supports an assigned book of business to achieve… more
- Elevance Health (Latham, NY)
- …or certification is a requirement for this position. + Previous experience in case management / utilization management with a broad range of experience with ... , offers superior clinical mental health and substance use disorder management , a comprehensive employee assistance program, work/life support, specialty programs… more
- Humana (Albany, NY)
- …and interpretation skills with prior experience leading teams focusing on quality management , utilization management , discharge planning and/or home health ... on continuously improving consumer experiences **Preferred Qualifications** + Medical management experience, working with health insurance organizations, hospitals and… more
- Albany Medical Center (Albany, NY)
- …and evaluation of services to patients and families + Collaborate with Risk Management , Patient Relations, Utilization Management , and Quality Management ... about potential problems and preclude outcomes detrimental to AMC + Base individual practice patterns on a sound knowledge base of social work principles and methodologies, social work policies, and the NASW Code of Ethics + Demonstrate flexibility in… more
- Molina Healthcare (Buffalo, NY)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... software program(s) proficiency. Preferred Qualifications * Certified Professional in Healthcare Management (CPHM). * Recent hospital experience in an intensive care… more
- Molina Healthcare (Syracuse, NY)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... software program(s) proficiency. Preferred Qualifications * Certified Professional in Healthcare Management (CPHM). * Recent hospital experience in an intensive care… more
- Humana (Albany, NY)
- …provisioning + EPIC analyst certification/accreditations as they related to business functions ( utilization management , care management , etc ) + Previous ... experience operating in electronic health records (such as Epic, Cerner, etc ) + Experience building digital capabilities + Demonstrated ability to develop and lead initiatives with influence + Possess a strong attention to detail and sound follow up skills +… more
- Evolent (Albany, NY)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more