- Helio Health Inc. (Syracuse, NY)
- …efforts to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ... the position and also take into account information provided by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case Management Position Type… more
- Healthfirst (NY)
- …case management, identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of ... LMSW, LMHC,LMFT, LCSW, PT, OT, and/or ST license + For Episodic Utilization / Case Management: NYS RN or Licensed Social Worker (LCSW/LMSW any state) **Preferred… more
- BronxCare Health System (Bronx, NY)
- …- Identify and report problematic cases with extended LOS providing updated information to Utilization Case Manager and /or Director for further action. ... Overview The Case Manager will coordinate care using...case management plan to assure appropriate and timely utilization of hospital, community based and other resources for… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/ Case Manager MSH Case ... utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... are not limited to: + Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using… more
- Mount Sinai Health System (New York, NY)
- …in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5 years ... **Job Description** The Case Manager (CM) will be responsible...1. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management… more
- BronxCare Health System (Bronx, NY)
- …- Establish and maintain positive relationships with patients, visitors, and other employees. Interacts professionally, courteously, and appropriately with patients, ... visitors and other employees. Behaves in a manner consistent with maintaining and furthering a positive public perception of Bronx-Lebanon Hospital Center and its employees. - Contributes to and participates in the Performance/Quality Improvement activities of… more
- Guthrie (Cortland, NY)
- … Case Management and Utilization Review position. The Acute Care Case Manager utilizes industry accepted processes for achieving timely, optimal patient ... safe discharge, based on assessed needs and available resources. The Acute Case Manager also performs Utilization Management throughout the continuum of care… more
- Ellis Medicine (Schenectady, NY)
- …The Discharge Planner's primary function is to work with the Social Worker, Nurse Case Manager , or Utilization Management Nurse to facilitate patient ... beneficiaries per CMS Conditions of Participation at the direction of the Case Manager . + Utilization Management Activities: + Collaborates with Case… more
- Northwell Health (Bay Shore, NY)
- …follow up and action. + * Acts as a liaison with patient's insurance carrier ( case manager , utilization reviewer) to coordinate post hospital services and ... as required. + * Participates in the maintenance of Utilization Management, Discharge Planning and Case Management statistics as required. + * Keeps abreast of… more
- VNS Health (Manhattan, NY)
- …Degree or equivalent work experience in management for a health plan or utilization / case management Required + Master's Degree in Nursing or Health Care ... management or related field, including three years of progressive experience in case or utilization Management Required + Effective oral/written communication… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals...in the area of nursing practice assigned; in this case , acute care utilization review. + Previous… more
- Mohawk Valley Health System (Utica, NY)
- RN - Utilization Management - Full Time - Days Department: CASE MANAGEMENT Job Summary The RN - Utilization Management gathers clinical information to ... as needed to appeal concurrent UR denials. + Complete daily utilization review of all observation/outpatient/in-bed patients. Collaborate with Care Manager… more
- Glens Falls Hospital (Glens Falls, NY)
- …at least 30 hours per week, can be foundhere. **Job:** **Nursing - Case Management* **Title:** *RN - Utilization Review Nurse* **Location:** *NY-Glens Falls* ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and removing… more
- Baylor Scott & White Health (Albany, NY)
- …Note: Benefits may vary based on position type and/or level **Job Summary** As a Manager for Utilization Review, you guide and supervise staff. You oversee care ... supervision of staff, resource management, and budget control. Departments involved are Utilization Management, Case Management, and Disease Management. + Ensure… more
- Guthrie (Binghamton, NY)
- Position Summary: The Acute Case Manager utilizes industry accepted processes for achieving optimal patient, clinical, and operational outcomes timely, ... coordinated, and in cost effective manners. The Acute Case Manager has the responsibility, accountability, and...in an acute care setting with strong care management, utilization review, and payer knowledge. A Case … more
- Mount Sinai Health System (New York, NY)
- …Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED patients and ... and identify the expected length of stay (ELOS). The case manager works collaboratively with physicians, social...* Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management… more
- WMCHealth (Kingston, NY)
- Case Manager - RN Company: HealthAlliance Hospital City/State: Kingston, NY Category: Nursing/Nursing Management Department: Case Management Union: Yes Union ... Responsibilities: + Maintains familiarity with the laws, regulations, and interpretation of utilization review and discharge planning. Remains up to date on changes… more
- Ellis Medicine (Schenectady, NY)
- …patient's required needs and covered services. Support services provided by the Case Manager include, but are not limited to, utilization review, case ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for ...inpatient experience in a hospital environment preferred. + Previous case management, utilization review, and discharge planning… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Health regulations. Monitor open encounters and report any issues to the Business Manager . Review utilization of services in order to comply with regulatory ... Job Summary: The Utilization Review Quality Assurance Coordinator is responsible for...patient care services are appropriately documented and utilized. Review case records to determine if patients are receiving appropriate… more
- Travelers Insurance Company (Buffalo, NY)
- …what you do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual base salary range provided for this ... Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for prospective,… more