- CVS Health (Albany, NY)
- …No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral health clinical experience in a ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- Independent Health (Buffalo, NY)
- … Utilization Review Clinician will primarily be responsible for managing behavioral health benefits through utilization management functions as well ... coordination setting required. + Experience in a health plan/managed care setting, utilization management , case management , and/or quality improvement… more
- Molina Healthcare (Albany, NY)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… more
- Molina Healthcare (Rochester, NY)
- …requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be ... **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has...an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high… more
- Molina Healthcare (Syracuse, NY)
- …Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …coordinates and is accountable for the daily work of employees who provide utilization management , clinical and medical necessity claim related services and ... + Current New York State clinical licensure (RN, Licensed Behavioral Health Clinician , PT, NP, PA, or...or Dietician) with a minimum of three years of utilization management /quality improvement experience or equivalent required.… more
- Garnet Health (Harris, NY)
- …case management , and discharge planning for non-psychiatric patients. The Clinician is also responsible for obtaining insurance approval for inpatient ... your career home with us as a Social Worker on our Inpatient Behavioral Health Unit (BHU) team at/in Garnet Health Medical Center-Catskill. Responsibilities The… more
- CenterWell (Albany, NY)
- …care that affect patient care and population management , such as quality management , utilization management , network management , and payment ... patients at national scale. S/he will be a proven clinician , leader, and strategist capable of driving the highest...quality/STARS, efficiency of care, and improved clinical outcomes and utilization . + Identify and act on opportunities to better… more
- University of Rochester (Brighton, NY)
- …who interact with the most challenging and vulnerable patient population in Behavioral Health clinical services. The Clinical Coordinator is also an integral member ... and data reporting. Work with Strong Ties leadership and Dept of Psychiatry Utilization Review team to address documentations concerns in a timely way and… more
- Trinity Health (Troy, NY)
- …Region. Ambulatory Care Behavioral Health Social Worker provides advanced clinician social work services, care planning, case management , and community ... actively participates in QI initiatives within the hospital ambulatory setting. The Behavioral Health Social Worker plays a significant role within our Accountable… more