- Arnot Health (Elmira, NY)
- …related to the management of patient care . The Case Manager will review all patients for utilization management and appropriate discharge planning. The ... participates in them. . The Case Manager tracks and trends LOS , resource utilization , outliers, readmissions , denials , delay days and satisfaction of the case… more
- University of Rochester (Rochester, NY)
- …work with staff on resolving discrepancies. + Utilize Tableau reports for operations, utilization , and revenues. + Build/edit and review reports for various ... with Dept. Billing Manager regarding billing operations procedures + Analyze, review and distribute monthly billing and financial reports. + Ensure insurance… more
- New York State Civil Service (Albany, NY)
- …services, premium software services and other service areas billed by this position.* Review and process service utilization and customer bills, work with ... the full range of activities in the design and/or review , analysis and management of accounting systems, resulting in...the full range of activities in the design and/or review , analysis and management of accounting systems, resulting in… more
- Humana (Albany, NY)
- …of action. The Policy Governance Professional 2 supports the ongoing development, review , and management of Utilization Management (UM) policies and procedures. ... and continuous improvement initiatives. Responsibilities: + Assist with the development, review , and maintenance of UM policy and procedure documentation, ensuring… more
- Molina Healthcare (Buffalo, NY)
- …to enterprise-wide strategies for integrated behavioral health programs, utilization management standardization, and cost-effective quality outcomes in a ... behavioral health clinicians responsible for prior authorization, inpatient concurrent review , discharge planning, care management, and interdisciplinary care team… more
- Northwell Health (New Hyde Park, NY)
- …the development, implementation, and maintenance of drug formularies, clinical utilization management (UM) criteria, and evidence-based drug therapy guidelines, and ... Responsibility** + Develops and monitors the hospital's policies/procedures regarding utilization of medications in collaboration with the medical staff, Pharmacy,… more
- RxBenefits (New York, NY)
- …channel management, B/G classifications, specialty designations, rebate eligibility, utilization trend, Utilization Management (UM) implications, Manufacturer ... structure, new prospect member size, marketing agreements, broker commissions, and drug utilization . + Be the SME on dozens of medical vendor/PBM contracts including… more
- BriteLife Recovery (West Kill, NY)
- …functions. + Under direction of supervisor, establish appropriate therapeutic boundaries, utilization of identified clinical resources to review boundaries, ... limit setting for behavior, and develop therapeutic relations with clients. + Assists in monitoring the therapeutic activities with patients., assist other team members as needed. + Work directly with the clients and provide proper recovery support. What we… more
- BriteLife Recovery (West Kill, NY)
- …functions. + Under direction of supervisor, establish appropriate therapeutic boundaries, utilization of identified clinical resources to review boundaries, ... limit setting for behavior, and develop therapeutic relations with clients. + Assists in monitoring the therapeutic activities with patients., assist other team members as needed. + Work directly with the clients and provide proper recovery support. + Special… more
- SUNY Geneseo (Geneseo, NY)
- …schedule and coordinate design meetings. Coordinate design reviews and collect design review comments from other College and customer units. - Attend design ... to issues of College standards, site management and constructability. - Review consultant prepared drawings and specifications for conformity with Campus standards… more