- CVS Health (Albany, NY)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST zones **Education**… more
- Highmark Health (Albany, NY)
- …needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise to design, develop, ... while also being capable of developing technical solutions. The consultant will act as a senior resource within the...the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The… more
- Highmark Health (Buffalo, NY)
- …set by the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... enrolled in Medicare STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected… more
- Oracle (Albany, NY)
- …Vitals Collection (MVC), and Infusion Suite. As an Integrated Technologies Consultant II, you will be responsible for providing consulting implementation services ... These services include the integrated technology deployments of hardware, software, and clinical workflow consulting. As a member of the CareAware Device Integration… more
- Mount Sinai Health System (New York, NY)
- …Patient screening 2) Patient/Family education 3) D/C planning and follow-up 4) Case management 5) Research + Maintains clinical expertise in area of ... as a consultant by: Serves as a consultant by: 1) Assisting clinical nurses and...of nursing the application of theory and research in clinical practice. + Participates in development and utilization… more
- Deloitte (New York, NY)
- Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk ... for both formal and informal education of physicians, CDI team, health information management and other clinical staff + Develop in-service education tools as… more
- UHS (Vestal, NY)
- …ensure the highest standards of patient care through effective resource coordination and utilization . In this role, you'll collaborate with clinical teams to ... of Clinical Operations and collaboratively with UHS Nursing, Quality Management , Risk Management , Performance Improvement, and other system members to… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …to its state licensure, third party administrators, utilization review and management requirements. The Manager of Compliance and Clinical Operations will ... maintenance of all HealthDirect policy and procedure. Responsible for the overall management of the clinical team and corresponding policy, procedure, and… more
- J&J Family of Companies (New York, NY)
- …and existing customers and performs account development activities creating competent, confident clinical + champions to drive the utilization of Monarch systems ... at https://www.jnj.com **Job Function:** MedTech Sales **Job Sub** **Function:** Clinical Sales - Specialty Physicians (Commission) **Job Category:** Professional… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …benefits and State and Federal Mandates and maintains current and working knowledge of Utilization Management Standards. + Clinical skills are excellent and ... area including, but not limited to, Medical and Pharmacy Utilization Management , quality management , member...at first level, appeal and inquiries. + Conducts peer-to-peer clinical reviews with attending physicians or other providers to… more