- Healthfirst (NY)
- …case management, identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of ... This position is 100% Remote** **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification… more
- Molina Healthcare (Yonkers, NY)
- …medications safety and medication use policies). **KNOWLEDGE/SKILLS/ABILITIES** The Pharmacist, UM will be responsible for reviewing coverage determinations and ... in a timely, compliant, and accurate manner. The Pharmacist, UM will also be responsible for serving as a...changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …for you, we encourage you to apply! Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department ... for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program… more
- Stony Brook University (Stony Brook, NY)
- Case Manager - Part Time Temporary **Position Summary** At Stony Brook Medicine, a **TH Staff Associate/ Case Manager ** is a valuable member of our team, ... high standard of excellence. **Duties of a TH Staff Associate/ Case Manager in the Care Management Department...their work and follow up with cases. **Preferred:** CM, UM , Quality, Coding, Risk or MCG Certification Working knowledge… more
- Ellis Medicine (Schenectady, NY)
- …Discharge Planner's primary function is to work with the Social Worker, Nurse Case Manager , or Utilization Management Nurse to facilitate patient discharge ... to make post discharge arrangements for patients. + Assists Case Manager or Social Worker by offering...insurance denials or quality improvement organization appeals. + Assists UM Coordinator with data entry of insurance authorizations and… more
- Mount Sinai Health System (New York, NY)
- …Vary) 8a-1p with Every Weekend** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring it reaches ... Word + Strong Communication skills Non-Bargaining Unit, BGG - Case Management - STL, Mount Sinai St. Luke's **Responsibilities**...departments + Monitors Concurrent Nurse denial phone calls for UM Nurse to follow + Prioritizes work as per… more
- Centene Corporation (New York, NY)
- …Health Counselor (LMHC), or Licensed Marital and Family Therapist (LMFT). Certified Case Manager (CCM) preferred.Pay Range: $55,100.00 - $99,000.00 per year ... environment (inpatient or outpatient). 1+ year of experience in Managed Care ( UM , BH, CM) preferred. Familiarity with Medicare and Medicaid programs preferred.… more