- MVP Health Care (Tarrytown, NY)
- …clinical nursing experience + At least 2 years of experience in utilization management of sub-acute Medicare reviews + Experience with Medicare guidelines ... RN licensure + Associate or bachelor's degree in nursing (BSN preferred) + Minimum 3 years of...interaction **Your key responsibilities:** + Conduct timely and accurate utilization reviews for sub-acute Medicare cases. + Evaluate medical… more
- Northwell Health (Staten Island, NY)
- …+ Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria + ... **Req Number** 167724 Registered Nurse Case Manager - FlexStaff Serves as liaison...Submits data to management regarding case management and/or quality initiatives… more
- Northwell Health (Mount Kisco, NY)
- …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + ... Submits data to management regarding case management and/or quality initiatives....Job Qualification + Graduate from an accredited School of Nursing . Bachelor's Degree in Nursing , preferred. Must… more
- Molina Healthcare (Yonkers, NY)
- …including design, development, implementation, and oversight of technology that drives core utilization management , care management , long-term services and ... management /leadership experience in a clinical leadership, clinical systems and/or informatics, utilization management , or care management role. *… more
- Crouse Hospital (Syracuse, NY)
- …a Registered Professional Nurse in New York State. + Recent acute care Utilization Management and Case Management experience. + Current certification in ... support systems. Coordinates financial and budgetary acquisitions, allocations and utilization of resources needed for quality, cost-effective, program(s)/service(s). +… 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
- CVS Health (NY)
- …+ 3+ years of experience in a managed care clinical operation environment ( utilization management , case management , and/or behavioral health case ... lives in new markets across the country. + The Nurse Educator will support the training and compliance monitoring...support the training and compliance monitoring of the DSNP/MMP Management team. They are responsible for conducting audits of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …assignments, difficult members and highly visible issues. + Understanding of the basic Utilization Management and Case Management aspects of the department ... and health care services for members. The SN CHA Nurse may also perform other technical and administrative tasks...and required. + Performs other functions as assigned by management . Minimum Qualifications: + RN with valid and current… more
- Catholic Health (West Seneca, NY)
- …a registered nurse required + One (1) year previous case, disease, or utilization management experience preferred + One (1) 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 (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
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