- Rochester Regional Health (Rochester, NY)
- …Life Support (BLS) certification PREFERRED QUALIFICATIONS + Acute care, chart review , utilization , or nursing triage experience strongly preferred. EDUCATION: ... to improve clinical practice. * Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research… more
- Elevance Health (Latham, NY)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
- Whitney Young Health Center (Albany, NY)
- …clinic. + Working collaboratively with clinical teams, coordinates various aspects of utilization and review and management + Working collaboratively with the ... human resources department, is responsible for hiring, counseling, disciplinary actions, and terminations. + Working collaboratively with the Director of Practice Operations and service line heads, is responsible for administering performance evaluations of… more
- CenterWell (Albany, NY)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
- CenterWell (Albany, NY)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical information ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay.… more
- New York State Civil Service (Albany, NY)
- …improvement, focus on prioritization and areas to be addressed through collaborative review and utilization of available data.* Serve as physician advisor ... Services.* Provide clinical recommendations to the Bureau of Service Allocation Research and Review (BSARR) regarding cases that do not meet standard level of care… more
- New York State Civil Service (Albany, NY)
- …Track recurring state assistance funding appropriations to ensure proper accounting and utilization of available funds.* Review budgets and Agency spending plans ... policies and advise DLF staff on appropriate procurement options for their project(s).* Review project or program scopes of work for quality and precision of work… more
- Terracon (Cheektowaga, NY)
- …operations of a department including staff training, development, and performance review , utilization of equipment and facilities, safety oversight, quality ... of services and work product, timely delivery of services and deliverables, and adherence to policies and procedure. Plan for and participate in business development activities to identify, develop, win, and execute project opportunities and build and maintain… more