- Albany Medical Center (Albany, NY)
- …Management /Social Work Work Shift: Day (United States of America) Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. Salary: $65,062.40 - $107,348.80 * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG criteria to… more
- Albany Medical Center (Albany, NY)
- …Management /Social Work Work Shift: Day (United States of America) Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. Salary Range: $31.28 - $51.61 per hour * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG criteria… more
- Elevance Health (Latham, NY)
- **Clinical Operations Medical Director** ** Utilization Management of Medical Oncology Benefits** **Carelon Benefits Management ** **$20,000 Sign On Bonus** ... members and providers. **Job Summary:** + Perform physician-level case review , following initial nurse review ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- Lincoln Financial Group (Albany, NY)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Albany Medical Center (Albany, NY)
- …proactively with the Quality Improvement Teams, patient care standards, Social Work, and utilization management to coordinate the appropriate use of resources to ... appropriate LOS and financial constraints. c. Provides collaborative care management with the primary nurse in assessing...the referral process and use of community resources. 2. Utilization Review a. Reviews data from admission… more
- Albany Medical Center (Albany, NY)
- …+ Basic knowledge of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or Compact ... works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to… more
- Ellis Medicine (Schenectady, NY)
- …is to work with the Social Worker, Nurse Case Manager, or Utilization Management Nurse to facilitate patient discharge plans, support coordination ... relationships with payers and communicates confidential information per policy. + Assists Utilization Management with initial clinical review requests as… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management , care transition, collaboration with physicians ... experience in a hospital environment preferred. + Previous case management , utilization review , and discharge...transition of care with Social Worker + Serves as nurse consultant for Social Worker cases with Clinical or… more
- Ellis Medicine (Schenectady, NY)
- …for the comprehensive integration of Discharge Planning, Performance Improvement and Utilization Review activities at patient, hospital, and system levels. ... licensed to practice as a RN in New York State. Experience: Previous Utilization Review , Quality Assessment, Discharge Planning or Home Care experience is… more
- CenterWell (Clifton Park, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...and reliable transportation. + Two years as a Registered Nurse with at least one-year of management … more
- Albany Medical Center (Albany, NY)
- …years in health care, involving benchmarking of data. + Demonstrated progressive management experience, minimum 3-5 years. Skills, Knowledge & Abilities: + Knowledge ... of Workday and Epic is preferred, or knowledge of a similar material management system is required. + Able to communicate effectively at all levels within the… more
- Albany Medical Center (Albany, NY)
- …short- and long-term goals and objectives. As a member of the nursing executive management team, the AVP participates in the efficient and effective management ... ensure compliance with all regulatory standards. + Planning and Program Management : + Provides administrative direction and coordination in the formulation,… more
- Trinity Health (Albany, NY)
- …Skilled Nursing Facilities have a unique opportunity for a RN to receive, review and process referrals of patients at St. Peter's Hospital referred for subacute ... is to provide on-site support and assistance to hospital case management and hospitalist team to ensure timely identification of inpatients appropriate… more
- New York State Civil Service (Schenectady, NY)
- …research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or ... level psychologist, licensed psychologist, licensed physician, licensed psychiatrist, psychiatric nurse practitioner, or licensed clinical social worker (or in the… more
- Trinity Health (Schenectady, NY)
- …referral sources, and external payers regarding the effective and efficient utilization of program services and available resources.** **Screening of clients through ... on site and/or telephonic assessment and record review in collaboration with physicians, nurses, therapists, social workers, case managers and other… more
- CVS Health (Albany, NY)
- …Office Suite (PowerPoint, Word, Excel, Outlook, Teams) Preferred Qualifications + Case management and/or utilization review experience + Leadership ... (but is not limited to):- Overseeing the implementation of healthcare management services for assigned functional area Implementing clinical policies & procedures… more