- Zurich NA (Albany, NY)
- AVP, Utilization Review & Pharmacy 123092 Zurich Insurance...a home -based office. As the AVP of Utilization Review & Pharmacy, you will lead and ... is seeking an AVP, Utilization Review & Pharmacy. This is a...is seeking an AVP, Utilization Review & Pharmacy. This is a fully remote position,...direct a team of Utilization Review and Pharmacy nurses who are… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... environment.* Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal communication skills.*… more
- Evolent (Albany, NY)
- …mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Utilization … more
- Humana (Albany, NY)
- …is responsible for overseeing and managing risks associated with Medicaid utilization management (UM) programs to ensure compliance with MHPAEA regulations. This ... stakeholders to ensure audit readiness. Humana is seeking a seasoned expert in Utilization Management to join the UM Risk Management team and help support Medicaid… more
- Catholic Health Services (Melville, NY)
- …has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. ... Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews...care to MCC in response to physician order, or review of updated clinical information Acts as a resource… more
- Loretto Management Corporation (Syracuse, NY)
- …organized manner. + Works in collaboration with the Director of Utilization Management/Information Systems for review of hospitalizations with extended ... Overview PACE CNY is currently hiring for a Home Care Coordinator RN! The Home ...visit/call contracted skilled nursing and enriched living facilities to review care needs, discuss participants' status/progress updates and communicate/share… more
- New York State Civil Service (Montrose, NY)
- …Community Mental Health Nurse, (including all parenthetic), Infection Control Nurse, or Senior Utilization Review Nurse;Or 2. One year in any Grade 16 or ... Health, Department of Title Registered Nurse Supervisor 1 (NY HELPS) (Veterans Home at Montrose) - 90208 Occupational Category Health Care, Human/Social Services… more
- Bassett Healthcare (Cooperstown, NY)
- …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. Identifies expected outcomes individualized to the… more
- Guthrie (Corning, NY)
- …and autonomy in nursing practice. Preferred experience with PCMH process, care management/ utilization review , and payer knowledge. Fast paced ambulatory care ... as a practice support in the Patient Centered Medical Home development and process. The position is an integral...is an integral part of the Patient Centered Medical Home Team. The PCMH Care Coordinator has the responsibility… more
- Heritage Ministries (Greenhurst, NY)
- …field. + Master's Degree preferred. + Professional license in Nursing Home Administration required. Responsibilities: + Ensure the development and implementation of ... in the organization's commitment to its employees, residents, and larger community. + Review monthly facility operating and budgetary statements + Ensure the proper … more