- RTX Corporation (Albany, NY)
- …and integrity + Establishing governance frameworks to ensure effective application lifecycle management + Utilization of the best practices, frameworks and tools ... position is to join our RTX Enterprise Services team:** Application Portfolio Management (APM) Lead within the Digital function, responsible for: + Establishing a… more
- Highmark Health (Albany, NY)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- AON (New York, NY)
- …and ability to work with others. + Experience in resource deployment and utilization management . + Strong interpersonal skills, with the ability to interact ... to work with others. + Experience in resource deployment and utilization management . + Strong interpersonal skills, with the ability to interact effectively… more
- Molina Healthcare (Rochester, NY)
- …and recommendations to vendors as needed. * Assists in preparation of documents for utilization management , care management , state, CMS, NCQA and other ... * At least 3 years' health care experience in care management , utilization management , behavioral health, medical, and/or managed care setting,… more
- Catholic Health (Buffalo, NY)
- …experience as a registered nurse required + One year previous case, disease, or utilization management experience preferred + One year previous experience in a ... illness, improve compliance with evidence based clinical guidelines, encourage patient self- management , increase coordination of care, increase the utilization … more
- Catholic Health Services (Port Jefferson, NY)
- …for patients across the acute care continuum. Perform required activities for utilization management , PRI assessment and completion, transition planning, and ... Years acute care clinical RN experience required Prior RN experience in Utilization Management , Performance Improvement, Transition Planning and/or Care … more
- Albany Medical Center (Albany, NY)
- …proactively with the Quality Improvement Teams, patient care standards, Social Work, and utilization management to coordinate the appropriate use of resources to ... Department/Unit: Care Management /Social Work Work Shift: Day (United States of...including pre-admission, discharge, post-discharge, planning length of stay, and utilization of resources. e. Utilizes own special body of… more
- Molina Healthcare (Rochester, NY)
- …Degree in Behavior Analysis or a related field. **Preferred Experience** Utilization Management experience Health Plan/MCO work experience **Preferred License, ... of stay for requested treatments and/or procedures. * Works collaboratively with the Utilization and Case Management departments to provide ABA/BHT services to… more
- Stony Brook University (Stony Brook, NY)
- …telephonically post-discharge and assist with barriers to care * Prior experience with Care Management or Utilization Management * Understand levels of care ... is provided to the patients. * Documents the case management plans such as clinical needs, barriers, utilization... management plans such as clinical needs, barriers, utilization of resources via assessments and/or progress notes. *… more
- Centene Corporation (New York, NY)
- …preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. NYS RN license required ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more