- Elevance Health (New York, NY)
- **Clinical Operations Medical Director** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
- Catholic Health Services (Smithtown, NY)
- …patients across the acute care continuum. + Performs required activities for utilization management , PRI assessment and completion, transition planning, and ... clinical medical/surgical or specialty experience required. + 2-3 years' Utilization Management , Performance Improvement, Transition Planning and/or Care… more
- Albany Medical Center (Albany, NY)
- …short- and long-term goals and objectives. As a member of the nursing executive management team, the AVP participates in the efficient and effective management ... Licensure, Certification & Registration: + Must hold a current NYS Registered Nurse license. Experience: + 7-10 years of experience in nursing, involving… more
- MVP Health Care (Rochester, NY)
- …with children and/or adolescents, with at least 2 years being ASD related + Utilization or Case Management experience in a managed care organization is preferred ... Workplace** . The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental health and substance use treatment decisions. This… 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 ... or emergency room. Preferred Experience Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of… more
- New York State Civil Service (Valatie, NY)
- …assignments as directed; these assignments include risk assessments, risk management plans, competency evaluations and diminution assessments; perform routine ... homes, as well as discipline-specific projects, including assisting with enhancing utilization of electronic health records, participation in relevant committees and… more
- Northwell Health (Melville, NY)
- … Review standard and regulations. + Performs concurrent and retrospective utilization management using evidenced-based medical necessity criteria; conducts ... + Inpatient clinical experience; 4+ years preferred. + Prior Acute Case Management and/or Utilization Review experience, preferred. + Must have experience… more
- Nuvance Health (Poughkeepsie, NY)
- …Course. The hyperbaric chamber operator assists in the provision of safe and therapeutic management of patient care to an assigned group of patients through the ... utilization Standards of Practice and policies and procedures and...patient care within the scope of practice as a Nurse (RN or LPN), Respiratory Therapist, EMT, Paramedic. *… more
- University of Rochester (Brighton, NY)
- …results received and acted upon as needed + Document plan of care, patient utilization , care management activities and other required information in state and ... and internal equity considerations._ **Responsibilities:** Provides professional comprehensive care management services to patients of the Strong Memorial Hospital,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and ... within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and… more