- Intermountain Health (Albany, NY)
- …in accordance with contractual requirements and communicates with care managers, utilization review RNs, revenue cycle, and payers as needed to coordinate ... and retrieves medical records from Health Information Management for retrospective utilization review or quality assurance. + Delivers routine regulatory notices to… more
- Outreach Development Corporation (Brentwood, NY)
- …Complete all documentation (ie, progress notes, group notes, treatment plans, utilization reviews, progress reports to referents, thresholds, active caseload lists, ... to integrate and enhance clinical services. + Submit weekly schedules, ensure prior approval for offsite activities, monitor and enhance effective utilization … more
- Elevance Health (Latham, NY)
- …there is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with complex ... psychiatric/substance abuse cases required. + Prior managed care experience required. **Preferred Skills, Capabilities, and Experiences:** + Utilization … more
- Resource Center for Independent Living (Utica, NY)
- …each participant/Designees/COS to review SD program requirements and expectations prior to acceptance. + Communicate effectively with each Participant/Designees/COS ... to ensure full understanding of program, as well as utilization of tools, resources and systems. + Act as...compliance with all applicable SD rules and regulations. Teach utilization of Electronic Health Record (EHR) system. + Interface… more
- Highmark Health (Albany, NY)
- …Description :** **JOB SUMMARY** This job is responsible for completing all Prior Authorization outbound call tasks and/or inbound triage case creations. In ... requested authorization. **ESSENTIAL RESPONSIBILITIES** + Obtain call task from Utilization Management platform, perform verbal outbound call task requirement… more
- CenterWell (Albany, NY)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical ... Heart, Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's degree in… more
- University of Rochester (Rochester, NY)
- …Medicare and other payer regulations for the coordination of benefits. + Notify Utilization Management of clinical requests by third party payers. + Maintain a ... Enrollment & Outreach, Financial Assistance, Registration and Insurance Management, Utilization Management, Social Work, Patient Accounts, Medical Records, Surgeon… more
- Touro University (Hawthorne, NY)
- …patients, ensuring teamwork among them + Increase student productivity by maximizing space utilization + Manage the population of patients assigned to the clinic by ... and backfill patients into student provider open slots, review phone call and utilization reports to aid in optimal use of chair time, update scheduled patient… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory ... of the Case Management department functions including quality, productivity, utilization performance, and educational needs to address established policies and… more
- MTA (New York, NY)
- …It also evaluates and integrates emerging technologies to improve data utilization , streamline workflows, and drive continuous improvement in operational efficiency ... of the latest advancements in data-driven technologies to continuously improve data utilization for analysis and reporting. + Collaborate with various MNR operating… more
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