- Fresenius Medical Center (Staten Island, NY)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Mount Sinai Health System (New York, NY)
- …to: a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using standardized ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will...Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case… more
- Fresenius Medical Center (Mineola, NY)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Nuvance Health (Carmel, NY)
- …in an acute care setting; Leadership experience preferred; Utilization review , discharge planning or case management experience preferred. Location: ... Carmel-PHC 670 Stoneleigh Avenue Work Type: Full-Time Standard Hours: 37.50 FTE: 1.000000 Work Schedule: Day 10 Work Shift: This is a Monday thru Friday position with rotating weekends. 8am-4pm Org Unit: 1168 Department: Care Coordination Exempt: Yes Grade:… more
- Guthrie (Binghamton, NY)
- …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care...in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, process and procedures ensuring accurate member care ... Supervisor is responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... - SNH is responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include… more
- Molina Healthcare (Yonkers, NY)
- …learn new programs. Preferred Qualifications * Experience with utilization /quality program management . * Managed care experience. * Peer review experience. * ... of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies… more
- DePaul (Rochester, NY)
- …the Quality Management Plan within the corporation. + Incident Management - review incident reports and provide feedback and recommendations(site-specific). ... trends for reporting and follow-up consultation and training. + Responsible for Utilization Record Review functions to include Individual record audits,… more
- Kaleida Health (Buffalo, NY)
- …In addition to daily oversight of operations, the VP will partner with Utilization Review , Revenue Cycle, and Clinical leadership to create patient/family ... Business field preferred. RN licensure required.** **Experience** **10 years of care management / utilization management experience required in hospital and/or… more