- Kaleida Health (Buffalo, NY)
- …for HighPointe on Michigan and DeGraff Rehabilitation and Skilled Nursing Facility. Interprets and implements quality assurance, performance improvement and ... tracking and reports of findings; integrates quality and safety with risk management activities. Ensures that the facility/entity activity is consistent with the… more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …party payers + Proactively communicates with Administrator and Director of Nursing to identify regulatory risk, effectiveness of Facility/Community Systems that ... appropriate follow-up action is taken + Facilitates the Care Management Process engaging the resident, IDT and family in...Analyzes QI/QM data in conjunction with the Director of Nursing Services to identify trends on a monthly basis… more
- Mount Sinai Health System (New York, NY)
- …or medical economics departments highly valuable. + Experience as a nurse informaticist highly valuable. + Experience working in healthcare provider analytics ... related to revenue modeling, managed care contracting, population management , case management , clinical or financial decision report + PhD, MD or DO program may… more
- Stony Brook University (Stony Brook, NY)
- … experience or an Associate's degree with at least 5 years of acute care nursing experience and case management experience. A candidate should have a good ... excellence. **Duties of a Care Manager in the Care Management Department may include the following but are not...the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity… more
- Sedgwick (Albany, NY)
- …needs, gives appropriate clinical options, and provides education to clients, nurse team, and treating physicians; develops specialized training for nurses to ... with client. + Maintains accurate record system of pharmacy utilization review and complex pharmacy reviews to include cost...complex review of cases to identify referral for case management as needed. + Participates in client meetings and… more
- Highmark Health (Buffalo, NY)
- …result in the greatest ROI for the Organization. Further, in a matrix management environment, will be responsible for collaborative work with the other members of ... and interpretation of claims submission for superior coding accuracy, cost and utilization reports, medical loss ratio reports, Medicare STARS gaps and other risk… more
- Catholic Health Services (Melville, NY)
- …health system. Partners with clinical and operational teams (eg, patient placement, nursing leadership, care management ) to ensure workflows and system ... Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …eligibility. Applies scheduling priority guidelines, adheres to CC consult management timeliness metrics. Ensures designation of patient desired in-network community ... and schedule care with community providers. Effectively uses Provider Profile Management System (PPMS) when scheduling care in the community. Accommodates patient… more
- HCR Home Care (Batavia, NY)
- …using the development of person-centered goals, culturally competent care management , and professional healthcare and social service coordination. Health Home ... - and short-term plans, when appropriate , including the utilization of community supports with the goal of reducing...and accurately use multiple software systems to capture care management notes and related activities, and to provide correction… more
- Fallon Health (Buffalo, NY)
- …the elderly for more than 100 years, through both community-based programs and nursing facility care. It is a renowned geriatric education and training institution ... team members, as appropriate, to accomplish these tasks at the day center, nursing home, or participants' homes.* + Ensures communication of participant changes to… more