- 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
- 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 (Albany, 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 (Albany, 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
- 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
- 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