- Mount Sinai Health System (New York, NY)
- …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
- WMCHealth (Valhalla, NY)
- … Coordinator Company: Westchester Medical Center City/State: Valhalla, NY Category: Nursing / Nursing Management Department: Clinical Care Management ... the implementation or investigation of the procedures specified in the Quality Management , Utilization Review and Discharge Planning Program at Westchester… more
- Catholic Health Services (Melville, NY)
- …queries from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, ... has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a...current with industry standards and business objectives related to Utilization and Care Management as appropriate. Sound… more
- Arnot Health (Elmira, NY)
- …with a current license as a registered nurse . BSN or Case Management Certification preferred. EXPERIENCE: Three years clinical nursing in acute care hospital ... care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The...approved registered nursing program… more
- Stony Brook University (Stony Brook, NY)
- …including managing Case Management leadership and staff functions related to case management and utilization management activities. + Manage and mentor a ... design, development, implementation, and monitoring of the organization's case management and utilization review functions. + Lead...* Possession of license to practice as a registered nurse in New York State * Certification in ACM… more
- Crouse Hospital (Syracuse, NY)
- …day management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... Manager who is responsible for providing day to day management of the RN Care Managers in the department....Manager, Care Coordination Requirements: + Licensed as a Registered Nurse in New York State + Bachelor's degree +… more
- Evolent (Albany, NY)
- …sources to establish and maintain the definitive source of truth for specialty Utilization Management (UM) agreements. This important work is achieved through ... Minimum 3 years of professional experience in value-based healthcare analytics or utilization management within a payer, provider, clinical vendor, managed care,… more
- Northwell Health (Staten Island, NY)
- …another level of care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for ... Nursing , required. + Current license to practice as a Registered Professional Nurse in New York State. + Case Management Certification, preferred. + Minimum… more
- Molina Healthcare (Albany, NY)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of the Medical Services area including, but not limited to, Medical and Pharmacy Utilization Management , quality management , member care management , and ... State and Federal Mandates and maintains current and working knowledge of Utilization Management Standards. + Clinical skills are excellent and evidence-based… more