- Phoenix House (Wainscott, NY)
- ** Utilization Review Manager ** **Job Details** **Job Location** East Hampton Residential - Wainscott, NY **Position Type** Full Time **Education Level** ... Shift** Morning **Job Category** Nonprofit - Social Services **Description** **SUMMARY** The Utilization Review (UR) Manager coordinates commercial, and… more
- Mount Sinai Health System (New York, NY)
- …+ Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... **Job Description** **RN/Case Manager MSH Case Management PT Days** The Case...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
- Mount Sinai Health System (New York, NY)
- …preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... **Job Description** The Case Manager (CM) will be responsible for all aspects...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
- Healthfirst (NY)
- **Duties/Responsibilities:** + Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review , ... reviews medical charts to obtain additional information required for appropriate utilization management and to solve complex clinical problems + Allocate, monitor,… more
- Samaritan Daytop Village (Rhinebeck, NY)
- …and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory staff as ... needed with assuring compliance with external and internal utilization review /quality and appropriateness requirements. What qualifications do you need: +… more
- Elevance Health (Latham, NY)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... and ensures essential face-to-face onboarding and skill development. The ** Utilization Management Representative I** will be responsible for coordinating cases… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …pertaining to its state licensure, third party administrators, utilization review and management requirements. The Manager of Compliance and Clinical ... and programs. **Job Summary:** Reporting to the Director of Operations, the Manager of Compliance and Clinical Operations is responsible formaintaining an effective… more
- Albany Medical Center (Albany, NY)
- …Demonstrates experience in the referral process and use of community resources. 2. Utilization Review a. Reviews data from admission screening to clarify ... of America) Salary Range: $71,612.39 - $110,999.20 The Case Manager is accountable to facilitate the interdisciplinary team to...Basic knowledge of computer systems with skills applicable to utilization review process. Mission, Core Values and… more
- Northwell Health (Staten Island, NY)
- …case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. + Keeps ... concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of stay. + Contacts… more
- Ellis Medicine (Schenectady, NY)
- …provided by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and social ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for case management of assigned...in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly… more
- Arnot Health (Elmira, NY)
- …related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case ... of self and other case managers. f. The Case Manager tracks and trends LOS, resource utilization ,...Case Manager tracks and trends LOS, resource utilization , outliers, readmissions, denials, delay days and satisfaction of… more
- CenterWell (Westbury, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- Guthrie (Binghamton, NY)
- …(5) years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtain ... Position Summary: The Acute Case Manager utilizes industry accepted processes for achieving optimal patient, clinical, and operational outcomes timely, coordinated,… more
- Cherry Bekaert (Albany, NY)
- …and tools to support Cherry Bekaert's (https://www.cbh.com/) growth. As a Resource Manager you are collaborating with executive and staff-level professionals in this ... highly visible role. As a Resource Manager you will implement leadership strategies while executing the...accurate and timely report analysis related to projected/actual hours, utilization and headcount at both an organizational level and… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... Case Manager **Position Summary** At Stony Brook Medicine, a...cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to… more
- Akin Gump Strauss Hauer & Feld LLP (New York, NY)
- … through ongoing communication with partners, associates and staffing personnel. Review utilization reports and raise productivity issues as appropriate. ... Asia and the Middle East. We are currently seeking a Corporate Practice Manager in our Client Value & Practice Management department, reporting directly to the… more
- Arnot Health (Bath, NY)
- …for professional/practice development. + Completes employee evaluations within the month of review date. Standard III. Education The Nurse Manager acquires and ... suitable for nursing research. + Promotes research-based practice. Standard VIII. Resource Utilization The Nurse Manager evaluates and administers the resources… more
- Elderwood (Buffalo, NY)
- …concerning the operation of the RN Care Management Team 4. Participate in the utilization review process and evaluate to determine if the member's condition and ... Salary Starting at 90,000 / Year Overview The Manager of Nursing is responsible for the RN...while also focusing on quality, gaps in care, and utilization . 2. Assist the Director of Nursing in planning,… more
- Highmark Health (Albany, NY)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more