- Healthfirst (NY)
- The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review, discharge planning, ... and case management as assigned. The Case Manager , Utilization Management is also responsible for efficient utilization of health services and optimal health… more
- Elevance Health (Latham, NY)
- …and insightful analytics to improve the delivery of care. **Behavioral Health Care Manager II - ABA** Location: **Virtual** - This role enables associates ... 8:00 am to 5:00 pm** The **Behavioral Health Care Manager II ** is responsible for managing autism...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …the Health Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates and utilizes corporate applications; core claims ... and subscriber agreement parameters, and required criteria. + Validates relevant UM /BH/MCM/Quality voice and email inboxes and/or Stored + Information retrieval… more
- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for ... for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program… more
- CDPHP (Latham, NY)
- …values and invites you to be a part of that experience. Conducts case management program activities in accordance with departmental, corporate, NYS Department of ... 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)
- RN Case Manager **Position Summary** At Stony Brook Medicine, a **RN Case Manager ** is a valuable member of our team, who provides clinical services to ... our high standard of excellence. **Duties of a RN 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