- CVS Health (Albany, NY)
- At CVS Health , we're building a world of health ...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized ... ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health ...day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual training.**… more
- CVS Health (Albany, NY)
- …Effective verbal and written communication skills - Bilingual a plus (Spanish) - Home Health experience - Hospice/palliative care experience - Associate's Degree ... At CVS Health , we're building a world of health...who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current… more
- Evolent (Albany, NY)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...Radiology you will be a key member of the utilization management team. We can offer you a meaningful… more
- Evolent (Albany, NY)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...Oncology, you will be a key member of the utilization management team. We can offer you a meaningful… more
- Kaleida Health (Williamsville, NY)
- …Nursing Experience required. 2 years of experience in any combination of case management, home care and utilization review preferred. Knowledge of and ... with members of the interdisciplinary team to coordinate care, facilitate utilization and resource management and discharge planning functions, working to achieve… more
- Ellis Medicine (Schenectady, NY)
- …in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly preferred. Home care, payer, or ... the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration...+ Adheres to the New York State Department of Health and Centers for Medicare and Medicaid Services discharge… more
- MVP Health Care (Tarrytown, NY)
- …experience. Experience working in a Medicaid Long Term Support Program (LTSS) or Health Home required. + Must demonstrate understanding of clinical and ... At MVP Health Care, we're on a mission to create...key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes assessment,… more
- Mohawk Valley Health System (Utica, NY)
- …Nurse. Core Job Responsibilities + Assists in provision of nursing care to the home health patient. Collaborates with the patient's primary case manager and ... seeking and obtaining sufficient information necessary to function effectively in the home health care setting. + Assumes responsibility to maintain and… more
- CVS Health (New York, NY)
- …consistent responses to members and providers. Leads all aspects of utilization review /quality assurance, directing case management Provides clinical expertise ... At CVS Health , we're building a world of health around... care resources. **This is a remote based (work at home ) based anywhere in the US.** Aetna, a CVS … more
- Catholic Health Services (Rockville Centre, NY)
- … system 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 ... Overview Catholic Health is one of Long Island's finest ...assigned reports and provide accurate and timely information for review by the Director of Reimbursement or their designee.… more