- Excellus BlueCross BlueShield (Dewitt, NY)
- …delivery of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered ... within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and… more
- Centene Corporation (New York, NY)
- …Interact with network practitioners to provide education on best practice models and utilization management processes + Interact with the Medical Director, or ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Molina Healthcare (Yonkers, NY)
- …suite/applicable software program(s) proficiency. Preferred Qualifications * Utilization management , care management , behavioral health and/or long-term ... Job Duties * Performs audits of non-clinical staff in utilization management , care management , member...services and supports (LTSS) non-clinical review /auditing experience. To all current Molina employees: If you… more
- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
- Molina Healthcare (Yonkers, NY)
- …Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health ... assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization… more
- Elevance Health (New York, NY)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... ** Behavioral Health Medical Director-Psychiatrist Appeals** **Location:** This role...Experiences:** + Child and Adolescent experience strongly preferred. + Utilization Management experience. + Applied Behavior Analysis… more
- Elevance Health (New Hyde Park, NY)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... ** Behavioral Health Care Manager II** A proud member...offers superior clinical mental health and substance use disorder management , a comprehensive employee assistance program, work/life support, specialty… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …Accountabilities: Level I + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. ... Performs medical review activities pertaining to utilization review...expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory,… more
- MVP Health Care (Rochester, NY)
- …senior leaders to promote appropriate care quality, service utilization , medication utilization and adherence, care management , and cost control. + Through ... To achieve this, we're looking for a **Medical Director, Behavioral Health Children's Services** , to join #TeamMVP. If...of NYS child serving systems. + Experience with critical review in clinical scenarios is desirable. + Knowledge of… more
- OLV Human Services (Lackawanna, NY)
- …navigating electronic health record (EHR) for documentation of services rendered. + Review utilization and service provision with supervisor + Coordinate and ... spouse completes too! Salary range: $18.22 - $26.00 per hour. The Youth Behavioral Support Caseworker provides direct services to children and families in their home… more