- Ellis Medicine (Schenectady, NY)
- …in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly preferred. Home care, payer, or ... services provided by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and… more
- Albany Medical Center (Albany, NY)
- …a changing environment. + Basic knowledge of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure ... service - required + Recent experience in case management, utilization management and/or discharge planning/ home care in a high volume, acute care hospital -… more
- Evolent (Albany, NY)
- …adjudication of processed appeals. **What You Bring:** + 1-3 years' experience in clinical Appeals Review or Utilization Management Review as an LPN or LVN ... appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and client policies...set up the appeal, physicians and other clinicians who review the appeal, the claims department to review… more
- Evolent (Albany, NY)
- …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- Community Housing Innovations (White Plains, NY)
- …and review all required pre-closing documents: mortgage loan commitment, home inspection report, HUD Planner's scope of work, 1003, purchase contract, title ... families and individuals live in quality housing, have a home of their own, and a job to support...homeownership applications, including organizing files and maintaining waitlist. + Review all grant applications to determine the eligibility of… more
- Arnot Health (Elmira, NY)
- …processes related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The ... f. The Case Manager tracks and trends LOS, resource utilization , outliers, readmissions, denials, delay days and satisfaction of...need and available resources. ** 16. Coordinates services, ie home help, DME etc, based on patient need and… more
- Humana (Albany, NY)
- …with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health ... health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review … more
- Humana (Albany, NY)
- …with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health ... health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review … more
- Humana (Albany, NY)
- …with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health ... health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review … more
- Nuvance Health (Poughkeepsie, NY)
- …or BSN preferred. Must have current RN license. Preferred experience in Utilization Review /Management.Company: Vassar Brothers Medical Center Org Unit: 1190 ... from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within the assigned… more