- NYS Housing Trust Fund Corporation (New York, NY)
- …mission is far reaching, encompassing single and multifamily housing finance, home improvement, rent regulation, housing subsidies, and community development. We ... the NYC waitlist, issuing additional vouchers as necessary to maximize utilization , assigning caseloads to staff, monitoring case management timeliness and accuracy,… more
- Molina Healthcare (Syracuse, NY)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and… more
- Catholic Health Services (Melville, NY)
- …Initiatives Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical ... York, as applicable. Certification by American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) preferred. 4. Knowledge, Skills and… more
- CenterLight Health System (NY)
- …of experience in care/case management, disease management, population health management, utilization review , quality assurance, or discharge planning (preferably ... clinical onboarding and reassessment, UAS-NY completion, comprehensive assessment, medication review , and post-hospital discharge evaluation. The Clinical Assessment Manager… more
- FlexStaff (New York, NY)
- …of experience in care/case management, disease management, population health management, utilization review , quality assurance, or discharge planning (preferably ... during home visits. Utilizes Lenavi analyzer during either the review process and/or assessment. Documents all interactions and outcomes in the designated… more
- Guthrie (Binghamton, NY)
- …(5) years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtain ... the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates the physician and other… more
- Spectrum Health and Human Services (Buffalo, NY)
- …Care Coordinator will be responsible for the following outcomes: to reduce utilization associated with avoidable and preventable inpatient stays, to reduce ... utilization associated with avoidable emergency room visits, to improve...to ensure client care plan needs/goals are met. + Develop/ review /revise the individual's plan of care with the client/family… more
- University of Rochester (Rochester, NY)
- …written and verbal communication and customer service skills. Financial Management + Review each visit for insurance history by utilizing the hospital system along ... Medicare and other payer regulations for the coordination of benefits. + Notify Utilization Management of clinical requests by third party payers. + Maintain a… more
- CenterWell (Albany, NY)
- …potential market events that would drive unanticipated changes in cost and utilization . The team also leads our trend detection process, responsible for identifying ... month, quarter over quarter and year over year trend review and ad hoc as needed + Proactively monitors...time that is best for your schedule **Work at Home requirements:** To ensure Home or Hybrid… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …management rounds. + Provision of clinical oversight and leadership to Utilization Management/Case Management (UM/CM) staff working with the children's population. + ... and PH care across the UM/ CM staff. + Participates in clinical peer review recruitment and supervision. + Collaborates with Provider Relations staff to ensure an… more