- Humana (Albany, NY)
- …Workforce Management team, supporting the Medicaid Inpatient and Outpatient Utilization Management segment. This role is responsible for executing ... our caring community and help us put health first** The Workforce Management Professional 2 applies and integrates advanced and predictive analysis, people metrics… more
- CVS Health (Albany, NY)
- …stakeholder engagement, and workflow optimization. + Familiarity with healthcare regulations, utilization management , case management , and general medical ... Senior Project Manager to lead clinical-focused initiatives supporting our Medical Management team. This role goes beyond traditional project management -it… more
- Bassett Healthcare (Cooperstown, NY)
- …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... barriers to efficient delivery of care in appropriate setting. + Completes utilization management and quality screening for assigned patients. + Applies… more
- Trinity Health (Troy, 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
- Mohawk Valley Health System (Utica, NY)
- …+ 3 years of clinical experience. + Strong computer skills. PREFERRED: + Case Management , Utilization Management and Quality Management experience ... Transitional Care RN - Case Management - Full Time - Days Department: CASE MANAGEMENT Job Summary The RN - Transitional Care Coordinator is responsible for… more
- Evolent (Albany, NY)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to ... meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use… more
- Highmark Health (Albany, NY)
- …residency program + 5 - 7 years in Pharmacy + 3 - 5 years in Pharmacist - Utilization Management + 3 - 5 years in Pharmacist - Medical Therapy Management ... to medication therapy are transitioned to a Pharmacist for Case & Disease Management (CMDM). The incumbent then conducts thorough research to evaluate the patient… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and procedures. This position accurately prepares and interprets cases for UM ( utilization management ) reviews and determination. In addition, the Technician is ... ensure delivery of consistent and quality health care services examples include Utilization Management , Quality Management and Case Management . +… more
- Northwell Health (Forest Hills, NY)
- …2. are appropriately arranged for and financially approved.Performs concurrent utilization management .Reviews appropriateness of patient's admission, need for ... (5) years clinical experience as a registered nurse. Prior experience in utilization management and/or discharge planning, preferred. A strong clinical… more
- Molina Healthcare (Buffalo, NY)
- …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental ... care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management programs for… more
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