- Molina Healthcare (Buffalo, NY)
- …healthcare services team supporting one or more of the following functions: care management , utilization management , care transitions, long-term services and ... * Actively participates in the department auditing program to review , communicate findings and identify opportunities for improved quality...at least 2 years of managed care experienced in utilization management * Registered Nurse (RN) ONLY… more
- Highmark Health (Buffalo, NY)
- …**Job Description :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent ... the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review ....job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Albany, NY)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review , the incumbent participates as the...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- City of New York (New York, NY)
- …data management , stakeholder collaboration, and capacity building to enhance behavioral health services for pregnant and parenting caregivers. Job Duties and ... stakeholders to enhance data-driven decision-making and cross-system referrals. - Review , synthesize, and report data findings, providing actionable recommendations… more
- University of Rochester (Rochester, NY)
- …NABITA rubric and implementing appropriate interventions. + Receive referrals from the Behavioral Intervention Team (BIT) to provide case management services and ... evening and weekend hours. **ESSENTIAL FUNCTIONS** CARE Student Case Management : + Maintain a caseload of CARE referrals for...students in need of additional support. + Conduct initial review of CARE referrals using the process of gathering… more
- WellLife Network (Bronx, NY)
- … contracts, quarterly summaries, collateral contacts. + Meet routinely with residents and management team to review goal progress, identify participant needs and ... update program plan and / or utilization of review plans. + Represent the...with clients. + Knowledge of addiction treatment models and behavioral health interventions. + Crisis intervention skills to handle… more
- CUNY (Brooklyn, NY)
- …service process, the resolution of student grievances, appeals, and complaints, and the utilization of the Behavioral Intervention Team (BIT). + Create and ... Advocacy and Accountability. Reporting to the Vice President for Enrollment Management and Student Affairs, the Manager of Student Advocacy and Accountability… more
- City of New York (New York, NY)
- …shared services functions across agencies, which results in better day-to-day management and building an integrated mission across agencies. DHS's mission statement ... risk of homelessness. Projects may include client linkage to case management services, medical/mental health/substance use treatment, or linkage to community-based… more
- Highmark Health (Albany, NY)
- …stakeholder concerns. **Key Responsibilities:** + Lead and participate in Architecture Review Board processes, providing expert guidance on cloud-based solutions and ... solutions, networks, and infrastructure. Ensure optimal technology selection, resource utilization , and seamless integration. + Utilize modeling tools to develop… more
- BriteLife Recovery (West Kill, NY)
- …Maintain compliance with regulatory, licensing, and accreditation standards (eg, audits, utilization review , quality assurance). + Participate in performance ... most talented and caring, authentic individuals to create a world-class mission-centered behavioral health organization, focused on doing it the right way If you… more
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