- Evolent Health (Albany, NY)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, … more
- Elevance Health (Latham, NY)
- **Anticipated End Date:** 2024-10-04 **Position Title:** Utilization Management Representative I **Job Description:** **Title: Utilization Management ... I** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50...50 miles of the Latham, NY pulse point. The ** Utilization Management Representative I** will be responsible… more
- Marriott (Albany, NY)
- …be employed by a franchisee and not by Marriott International, Inc. JOB SUMMARY: The remote role of the Director Revenue Management is to provide direction to ... **Job Number** 24136294 **Job Category** Revenue Management **Location** Laguna Cliffs Marriott Resort & Spa,...full service premium branded hotel. This position is a remote position encompassing 25% in the office or one… more
- Highmark Health (Albany, NY)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review , the incumbent participates as the...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- Sharecare, Inc. (Albany, NY)
- …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... members of the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager. All Sharecare clinicians… more
- Humana (Albany, NY)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, ...with prior experience participating in teams focusing on quality management , utilization management , case … more
- CVS Health (Albany, NY)
- …involving clinical issues * Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk ... clinical/medical programs * Provide psychiatric leadership to an interdisciplinary utilization management team, including medical/clinical oversight, consultation… more
- Highmark Health (Albany, NY)
- …Highmark Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Elevance Health (Latham, NY)
- …**How you will make an impact:** + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and ... Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles from our… 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
- 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
- CVS Health (Albany, NY)
- …basis to support 24/7 appeals work * IRE monitoring and tracking and Utilization Management Strategy support * Collaborative work with Medicare Quality and ... effective use of health care resources. **This is a remote based (work at home) based anywhere in the...policy and appeals to the appeal nurses and territory Utilization Management Staff * Participate in ongoing… more
- Verint Systems, Inc. (Albany, NY)
- …enrollment processes, including obtaining and analyzing benchmark data and utilization data, identifying trends, preparing recommendations with impact assessments ... covering the four pillars. + Responsible for all aspects of leave management , 401(k), tuition reimbursement, paid time off, annual holiday schedules and worker's… more
- Cardinal Health (Albany, NY)
- …and analyzing data and processes to support organizational leadership's planning, management and decision making for member practices and the broader Navista ... practices. + Responsible for analyzing data and processes to support planning, management , and decision making in coordination with Navista practices. + Creating… more
- HealthEdge Software Inc (Albany, NY)
- …for Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC ( Utilization Review Accreditation Commission) and other State regulatory bodies. The ... where they need it. We call it Digital Health Management . Our comprehensive suite of Digital Health Management...Work across multiple time zones in a hybrid or remote work environment. + Long periods of time sitting… more
- Elevance Health (Latham, NY)
- …communication documents to convey the determination. + Responsibilities exclude conducting any utilization or medical management review activities which ... I** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50...response in clear, understandable language. + Utilizes guidelines and review tools to conduct extensive research and analyze the… more
- Lincoln Financial Group (Albany, NY)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... Dover, NH (New Hampshire); Omaha, NE (Nebraska); Work from Home **Work Arrangement:** Remote : Work at home employee residing outside of a commutable distance to… more
- Confluent (Albany, NY)
- …Customer Solutions as well as cross-functional divisions such as Sales, Product Management and Engineering to help our customers accelerate time to value, maximize ... for operating and maturing their Confluent subscription. You will also utilize relationship management skills & industry experience to guide the customer on how they… more
- CBRE (Albany, NY)
- …Posted 29-Aug-2024 Service line GWS Segment Role type Full-time Areas of Interest Construction, Project Management Location(s) Remote - US - Remote - US - ... between the cross-functional teams + Draft program reporting for client management reviews, including providing health of program schedule, budget, and performance,… more
- Norstella (Albany, NY)
- Client Success Director Company: MMIT Location: Remote , United States Date Posted: Aug 29, 2024 Employment Type: Full Time Job ID: R-543 **Description** **Company ... smooth patient access to therapies, by ensuring successful deployment, adoption, and utilization of MMIT's products and services. The Client Success Director (CSD)… more