- Excellus BlueCross BlueShield (Rochester, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... Job Description: Summary: Conducts case management program activities in accordance with departmental,...Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist… more
- Rochester Regional Health (Rochester, NY)
- SUMMARY As a Registered Nurse - Care Manager , your excellent interpersonal, leadership and collaboration skills ensure the appropriate allocation of hospital ... ATTRIBUTES + Three (3) years of acute hospital care, case management or utilization management experience preferred + Excellent...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
- MVP Health Care (Rochester, NY)
- …you'll bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months after ... innovative thinking and continuous improvement. To achieve this, we're looking for a ** Case Manager , Medicaid Long Term Support Program** to join #TeamMVP. If… more
- HCR Home Care (Rochester, NY)
- Salary Range: $89,000.00 - $99,000.00 Annually Role and Responsibilities The Clinical Manager is an RN who supervises a potentially interdisciplinary team of RNs ... to Agency standards as well as legal/regulatory standards . + Conduct case conferences (informal, supervisory or interdisciplinary) to discuss client issues, plan of… more
- Molina Healthcare (Rochester, NY)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …compliance and regulatory requirements. Primary activities include substantiating referrals, case planning and research, conducting onsite or desk audits, clinical ... to identify red flags/aberrant billing patterns. + Manages cases as assigned, prioritizing case load as appropriate. Maintains case logs, prepares records and… more
- Molina Healthcare (Rochester, NY)
- …transitions, behavioral health, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ), Licensed Vocational Nurse (LVN), ... to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM),… more
- HCR Home Care (Rochester, NY)
- …as needed, and process recert/discharge decisions based on clinical documentation and input from case manager , based on case orders for tracking purposes and ... orders before they are sent to physician. Notify Clinical Manager when unable to approve the order. + Provide...in Nursing preferred. Qualifications and Requirements + Current, valid RN license, issued by NYS Department of Education required.… more