- Healthfirst (NY)
- … management, identifying alternative care options, and discharge planning** + **Certified Case Manager ** + **Interqual and//or Milliman knowledge** + **Knowledge ... This position is 100% Remote** **Duties//Responsibilities:** + **Provides case management services for assigned member caseloads which includes:** +… 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 (Dewitt, 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
- Bassett Healthcare (Cooperstown, NY)
- …optimum health and enjoy the best quality of life possible. What you'll do The Manager for Case Management and the Logistics Center is responsible for the ... Rounding, and facilitates Performance Improvement and A3 efforts for Case Management and the Logistics Center + Audits of...collaboratively with unit staff (charge nurse, staff nurse) unit manager , and support team ( UM , MSW, SW,… 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
- Highmark Health (Albany, NY)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over… 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