- Humana (Albany, NY)
- …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
- Excellus BlueCross BlueShield (Rochester, NY)
- … Management Department clinical staff . Acts as resource to Utilization Management staff , members and providers. + Provides backup for the ... if called upon, works directly with the operation and clinical staff to resolve issues and escalated...Bachelors degree preferred. + Minimum of three years of clinical experience required. Utilization Management … more
- Guthrie (Cortland, NY)
- Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and the Robert ... Packer Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… 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...payor criteria and issues and a case-by-case basis with clinical staff and follows up to resolve… more
- University of Rochester (Rochester, NY)
- …and assess compliance with regulations and standard operating procedures. **_Clinical Staff Pharmacist - Clinical Responsibilities_** + In coordination with ... the clinical pharmacy team, oversees the management of drug shortages in the pharmacy, including recommending alternatives, entering tickets for alerts in the… more
- Helio Health Inc. (Syracuse, NY)
- …program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management , ... track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our Inpatient,… more
- WMCHealth (Valhalla, NY)
- …or investigation of the procedures specified in the Clinical Care Management Department through review of the Utilization and Discharge Planning Program ... Supervisor Of Nursing - Clinical Care Management Company: Westchester Medical...Administrative supervision is exercised over a number of Case Management Staff within the primary areas of… more
- Northwell Health (New Hyde Park, NY)
- …is responsible for the development, implementation, and maintenance of drug formularies, clinical utilization management (UM) criteria, and evidence-based ... of clinical services. + Provides necessary, requested information to management for consideration in the staff 's performance appraisals; collaboratively,… more
- CenterWell (Westbury, NY)
- …for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, ... documentation in addition to feedback and recommendations by Utilization Review staff . Upon completion of the...systems and process. Competently performs patient care assignments and staff management activities. + Provides direct patient… more
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