- Nestle (Bohemia, NY)
- At Nestle Health Science, we believe that nutrition, science, and wellness must merge, not collide. Here, we embrace the intrinsic connections of these three ... aim to prevent, manage, and treat gastrointestinal and metabolic-related diseases. At Nestle Health Science, we bring our best for better lives. Our people are… more
- Evolent (Albany, NY)
- …experience and as an RN - **Required** + Minimum of 5 years in Utilization Management, health care Appeals, compliance and/or grievances/complaints in a quality ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies… more
- CVS Health (Farmingdale, NY)
- …your understanding of patient safety and error prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding ... culture of continuous improvement, with the goal of changing health care for the better. **Position Summary:** At CVS...an essential pharmacist function + Ability to work in home store, and across the market in other locations,… more
- CVS Health (Albany, NY)
- …experience in Health Care Delivery System eg, Clinical Practice and Health Care Industry. *Prior UM ( Utilization Management) experience *Active and current ... At CVS Health , we're building a world of health...care resources. **This is a remote based (work from home ) position.** Preferred candidates will have Internal Medicine or… more
- CVS Health (Albany, NY)
- At CVS Health , we're building a world of health...a Medical Director you will focus primarily on overseeing utilization review / quality assurance and be ... ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health ...care resources. This is a remote based (work from home ) role. Preferred candidates will reside in New Jersey… 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 ...patients and/or their caregivers. Responsible for accurate and timely review of discharged medications in the acute care areas.… more
- Kaleida Health (Williamsville, NY)
- …Suite and Outlook. 2 years of experience In any combination of: case management, home care and utilization review preferred. Knowledge of and experience ... experience in Acute care Nursing Experience required, use of computer applications related to health care industry required and working knowledge of Microsoft Office… more
- Catholic Health Services (Melville, 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 ...Experience with Lawson, Strata, and Essbase all a plus. Utilization of Microsoft Excel models for financial analysis purposes… more
- Humana (Albany, NY)
- …quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. ... insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization,… more
- Whitney Young Health Center (Albany, NY)
- …clinic. + Working collaboratively with clinical teams, coordinates various aspects of utilization and review and management + Working collaboratively with the ... Be a part of the mission at Whitney Young Health (WYH) to provide high quality healthcare that is...Committee for Quality Assurance (NCQA) and Patient Centered Medical Home (PCMH), works with the providers, care coordinators and… more