- Mount Sinai Health System (Long Island City, NY)
- …Description** The Director will direct and manage departmental activities involved in utilization review, appeals management and discharge planning to facilitate ... nursing or healthcare-related field **Experience Requirements** 5 years of Case Management and 6 years of clinical nurse experience. Previous supervisory experience… 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 ... Federal Mandates and maintains current and working knowledge of Utilization Management Standards. + Clinical skills are...of Medicine or Doctor of Osteopathic Medicine. + The Physician is not the subject of any pending professional… more
- Mount Sinai Health System (New York, NY)
- …and treatments plans are not required to be countersigned by a physician . **PRINCIPLES DUTIES AND RESPONSIBILITIES** **CLINICAL PRACTICE** + Assesses the health ... and counsels in the areas of health promotion, maintenance, disease prevention, and management of acute/chronic illnesses. + Documents findings and plan of care in… more
- Trinity Health (Syracuse, NY)
- …nurse that is accountable for applying positive strategies to promote operational management and supports an environment of excellence for the department. Guides ... hub team members; assists with schedules, evaluations, and performance management . + Supervises hub operations; establishes and maintains departmental processes… more
- Arnot Health (Elmira, NY)
- …$10,000 Sign on Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and ... other department staff 5. Relays denial information to appropriate billing clerks and management . 6. Follow up on denial claims using reports to ensure completion of… more
- Grifols Shared Services North America, Inc (New York, NY)
- …countries and regions. **Overview:** The primary responsibility of the Bleeding Management Hospital Specialty Sales Representative (HSSR) is to represent key ... products within the Bleeding Management product portfolio with a primary responsibility for the...relationships in institutions aligned with customer segmentation. + Develop physician influencer champions to submit and approve P&T requests… more
- Rochester Regional Health (Rochester, NY)
- …efficient utilization of resources. Carries out activities related to utilization management , discharge planning, care coordination and referral to other ... + Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care based on...hospital care experience not required. PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience… more
- Rochester Regional Health (Rochester, NY)
- …case coordination/patient navigation for patients, including triage management , algorithm management , utilization management and resource management . ... assist with continually improving the quality and effectiveness of case management /patient navigation. RESPONSIBILITIES + Reviews the medical record with referring… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title:** **Nurse Clinical Coordinator - Care Management ** + Mount Sinai Health Partners (MSHP) is the management services organization ... and health status, improve the health of patient populations and reduce utilization and healthcare costs. + Population health initiatives particularly focus on… more