- Helio Health Inc. (Syracuse, NY)
- …efforts to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ... position and also take into account information provided by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case /Care Management Position… more
- Ellis Medicine (Schenectady, NY)
- …to Medicare beneficiaries per CMS Conditions of Participation at the direction of the Case Manager . * Utilization Management Activities; Collaborates with ... Activities; Contacts referral agencies to make post discharge arrangements for patients. Assists Case Manager or Social Worker by offering choice of providers.… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/ Case Manager MSH Case ...or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or ... are not limited to: a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using… more
- Guthrie (Binghamton, NY)
- …clinical approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the ... On Bonus For Qualified RNs! Position Summary: The Acute Case Manager utilizes industry accepted processes for...in an acute care setting with strong care management, utilization review, and payer knowledge. A Case … more
- CDPHP (Latham, NY)
- …experience treating psychiatric and/or substance abuse patients is required. + Certified Case Manager (CCM) designation preferred. + PRI (Patient Review ... to be a part of that experience. The BH Utilization Specialist is responsible for coordination of care for...for CDPHP members through collaboration with the Outpatient Care Manager whose role it is to follow our member… more
- Molina Healthcare (Yonkers, NY)
- …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... and quality initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and cost control issues… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
- Ellis Medicine (Schenectady, NY)
- …patient's required needs and covered services. Support services provided by the Case Manager include, but are not limited to, utilization review, case ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for ...inpatient experience in a hospital environment preferred. + Previous case management, utilization review, and discharge planning… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …auditor within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and ... for you, we encourage you to apply! Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department… more
- MVP Health Care (Tarrytown, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a ** Case Manager , Medicaid Long Term Support Program** to join #TeamMVP. If ... key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that...medically complex Medicaid members. + Through collaborative efforts the Case Manager will identify the medical and… more