- 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
- Molina Healthcare (Syracuse, NY)
- …oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical ... working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
- Rochester Regional Health (Rochester, NY)
- …necessity in the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization , performing continued stay ... in the expected time frame and with most efficient utilization of resources. Carries out activities related to ...continuum. + Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care based… more
- New York State Civil Service (New York, NY)
- …Law Article 15-A and related regulations, and the MWBD Division, concerning the utilization of certified MWBEs on state contracts. Duties include but are not limited ... to assigned agencies/authorities.* Receive, analyze, and evaluate, and conduct primary review and take corrective actions on agency/authority annual goal plans and… more
- Humana (Albany, NY)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all… more