- Molina Healthcare (Albany, NY)
- …NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is ... responsible for developing, implementing, and monitoring the success of quality improvement interventions . The Manager works to coordinate resources and… more
- Baylor Scott & White Health (Albany, NY)
- **JOB SUMMARY** As a licensed clinician, the Clinical Program Manager is accountable for leading clinical programs, clinical performance, and/or contract ... obligations. + Proactively identifies, plans, implements, evaluates, and monitors quality improvement and performance improvement initiatives. + Significantly contributes… more
- Sharecare (Albany, NY)
- …support in an appropriate, efficient and cost-effective manner while ensuring high quality care. The Clinical Registered Nurse coordinates with the Primary ... total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible… more
- Public Consulting Group (Albany, NY)
- …* Document all care activity via case management software system * Promotes quality and cost-effective interventions and outcomes * Assesses and addresses ... a qualified Registered Nurse to perform as a Case Manager . The Case Manager will be responsible...accurately all necessary forms and produce statistical reports Promotes quality and cost-effective interventions and outcomes +… more
- Highmark Health (Albany, NY)
- …to appropriate multi-disciplinary resources. In addition to identifying the appropriate clinical interventions and referrals, the incumbent will manage an ... performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address member needs and/or triaging members… more
- Whitney Young Health Center (Albany, NY)
- …collects and documents clinical data and other data as required (ie clinical and referral logs, quality control documents). + Consistently utilizes available ... Registered Nurse (RN) Care Manager (Req 100826) Albany, NY (http://maps.google.com/maps?q=920+Lark+Drive+Albany+NY+USA+12207) Apply Description GENERAL… more
- Albany Medical Center (Albany, NY)
- …resources to achieve maximum clinical and financial outcomes. The Case Manager participates in maintaining quality care and performance improvement through ... care for assigned service line across the continuum of care. The Case Manager works proactively with the Quality Improvement Teams, patient care standards,… more
- Sharecare (Albany, NY)
- …2025** **Salary:** **$85,000 annually, plus comprehensive benefits package** The Care Manager supports the implementation of the Value Based Care Management program ... in an appropriate and efficient manner by providing high- quality telephonic Case or Care Management with CareFirst members. The Care Manager partners with… more
- Albany Medical Center (Albany, NY)
- …resources to achieve maximum clinical and financial outcomes. The Case Manager participates in maintaining quality care and performance improvement through ... service line across the continuum of care. The Case Manager works proactively with the Quality Improvement...the hospital pre and post-op. b. Proactively monitor patients' clinical process through /patient care standards and evidence based… more
- Molina Healthcare (Albany, NY)
- …plan to achieve performance goals. + Direct management of QS HPP program manager . Coordination with health plan quality staff. Ensure organization with other ... years of experience in Managed Care and/or health plan quality . Clinical experience is needed for positions...for positions that are focused on Accreditation, Compliance, HEDIS Interventions , Potential Quality of Care issues, and… more
- Molina Healthcare (Albany, NY)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified… more
- Centene Corporation (Latham, NY)
- …complex care management activities based on member activities to enable quality , cost-effective healthcare outcomes. Develops a personalized care plan / service ... families/care givers on services and benefit options available to receive appropriate high- quality care. + Develops and continuously assesses ongoing care plans /… more
- Elevance Health (Latham, NY)
- ** Clinical Operations Medical Director** **Carelon MBM** **Location:** Alternate locations may be considered. The ideal candidate will live within 50 miles of one of ... and providers. In this role, you will participate in pre-authorization and quality improvement solutions for both specialized cardiology and vascular surgery. This… more
- CVS Health (Albany, NY)
- …room utilization. + Assists in the identification and reporting of potential quality improvement issues. + Directs social work interventions including performing ... leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our **Dual Eligible… more
- Ellis Medicine (Schenectady, NY)
- …nursing staff members, supervises care and evaluates results. Maintains competence in clinical practice and assists in the development of nursing practice standards ... for the visit and over time of the relationship. 2. Identifies nursing interventions to meet goals. 3. Individualizes interventions according to patient assets… more
- Albany Medical Center (Albany, NY)
- …States of America) Salary Range: $38,937.60 - $50,618.88 Under the direction of the Clinical Nutrition Manager , provides clinical support to the team of ... pertinent clinical information back to the dietitians for further interventions as necessary and provides basic diet education when appropriate. Works closely… more
- Albany Medical Center (Albany, NY)
- …the quality of nursing care by applying appropriate nursing interventions , such as identifying and clarifying patient needs, performing procedures, conducting ... Under the Supervision of the Nursing Supervisor and/or Nurse Manager , the RN provides nursing support to primary and...+ Collaborates with administrative staff and physicians on the Quality Improvement Team to address clinical and… more
- Highmark Health (Albany, NY)
- …performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address member needs and/or triaging members ... panel of members that range in health status/severity and clinical needs; and assesses health management needs of the...personal health goals. Will work with providers to insure quality and appropriate care is being delivered in a… more
- Intermountain Health (Albany, NY)
- …services, addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management. **Job Specifics** + Pay Range ... **Job Description:** The Social Work Care Manager works collaboratively with physicians and other members...patient/member per CMS Condition of Participation (COP) or National Clinical Quality Association (NCQA) standards. Ensures a… more
- CenterWell (Albany, NY)
- … and operational area and/or related roles + Exposure or experience with clinical care delivery and interventions and/or care management + Experience leading ... safe, reliable pharmacy services and is committed to excellence and quality . Through our home delivery and over-the-counter fulfillment services, specialty, and… more