- Rise Life Services (Hampton Bays, NY)
- …data collection, progress notes, billing requirements. + Participates in bi-annual Utilization Management Reviews and ensures completion of Recovery ... etc. considering the Individuals' choices. + Thoroughly prepares for OMH/OMIG/Internal Management Audits; Conducts regular self-audits of records to identify areas… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …with CDPAS documentation and authorizations. PRIMARY RESPONSIBILITIES: + Point person for Utilization Management , Case Management and G&A regarding ... resolution to members request for a change in provider + Communicate with current provider regarding stabilizing services + Communicate with providers regarding staffing new cases + Assist delegating CDPAS documentation to appropriate departments + Correspond… more
- CDPHP (Albany, NY)
- …two (2) years experience in a health insurance related discipline required. + Utilization management experience is preferred. + Knowledge of managed care, health ... CDPHP and its family of companies include subsidiaries Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRx Services,… more
- Highland Hospital (Rochester, NY)
- …benefits, identifies and resolves coordination of benefits discrepancies, and notifies Utilization Management of additional clinical requests **Salary Range:** ... for out-of-network payers, refers our self-pay patients to Financial Case Management (FCM) for Medicaid assessment or Financial Assistance, reviews and validates… more
- Elevance Health (Latham, NY)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... complex psychiatric/substance abuse cases required. + Prior managed care experience required. + For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal… more
- Bowery Residents Committee (Manhattan, NY)
- …plans, and crisis intervention. Gather and review documentation as requested for utilization management reviews of clients on caseload including completion of ... MSW or CASAC-T License required. LMHC or LMSW preferred. Excellent time management skills. Bachelors strongly preferred. Knowledge of OASAS rules and regulations and… more
- Evolent (Albany, NY)
- …various sites of care/service is preferred + Familiarity with value-based care and utilization management is preferred + Understanding of data systems and the ... will partner closely with executives across analytics, finance, product and account management . **What You Will Be Doing:** + Support Business Development & Product… more
- Akin Gump Strauss Hauer & Feld LLP (New York, NY)
- …Management & Development + Work with Director to support workload management / utilization through ongoing communication with partners, associates and staffing ... Corporate Practice Manager in our Client Value & Practice Management department, reporting directly to the Director of Practice...personnel. Review utilization reports and raise productivity issues as appropriate. +… more
- Regeneron Pharmaceuticals (Tarrytown, NY)
- …Excel and PowerPoint; AutoCAD/Building Information Modeling/Revit, CAFM/IWMS or other space management / utilization software; knowledge of TRIRIGA a plus + Must ... customers (users), collaborators (leaders), and partners (Real Estate & Facilities Management , Research Operations) to understand user requirements and develop lab… more
- Independent Health (Buffalo, NY)
- …innovation and collaboration. **Overview** The UMA provides administrative support to the Utilization Management , departments. The UMA is the first line of ... review in the UM prior authorization process, reviewing for eligibility and benefit. The UMA is responsible for intake of clinical information, data entry of requests, preparation of the documents for clinical review and/or administrative review per standard… more