- Mount Sinai Health System (New York, NY)
- … Director (Licensed)** is responsible for leading and sustaining a Utilization Management Initiative supporting ACO and value-based care populations. This ... Therapy **Experience Requirements** + 7+ years of experience in care management , utilization management , population health, or value-based care. +… more
- Healthfirst (NY)
- …to maintain and improve department performance + Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement + Lead ... closely with other Operations leaders including but not limited to Care Management , Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to… more
- Insight Global (New York, NY)
- …turn-around times for clinical reviews. * Collaborate with other departments on Utilization Management Operations. * Lead key projects and drive initiatives ... leading and overseeing a team of physicians ensuring efficient management and adherence to quality standards. Primary Duties and...3+ years of clinical practice * 2+ years of utilization review experience in a managed care plan (health… more
- Humana (Albany, NY)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Albany, NY)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Samaritan Daytop Village (Queens, NY)
- …and agency administration. The Program Director will be responsible for census/ utilization management and quality assurance. What You Will Do + Supervise ... Community is Everything Help LEAD Yours! LCSW Program Director -OASAS Facility Staten Island Social Workers, psychotherapists and mental health professionals can work… more
- Evolent (Albany, NY)
- …LMSWs, LCSW, and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing… more
- Guthrie (Cortland, NY)
- …for those with less than one year of experience) Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic ... Packer Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior… more
- Albany Medical Center (Albany, NY)
- …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG...in both areas.* Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures… more
- Mount Sinai Health System (New York, NY)
- …: + Active RN license in the state of employment required + Certification in Case Management (CCM, ACM) or Utilization Management preferred. + 7+ years of ... **Job Description** ** Director Pre Appeals Management -HSO Appeals ...experience in clinical acute clinical, utilization management , appeals management or… more