Utilization management jobs in Corona, NYCreate job alerts

Minimum of four years experience in home care, care management or related field, including three years of progressive experience in case or utilization Management Required. Generates management reports via the care/utilization management systems and demonstrates competency as a super user of thes...

The Case Management Care Coordinator, Utilization Management is a member of the healthcare team and is responsible for coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilizatio...

Utilization Management Specialist MSH Case Management FT Days. Position responsibilities will include utilization management support functions for patient admissions and continuing stay. This position also facilitates and tracks concurrent adverse determinations and collaborates with Appeals Mana...

Supervise the management of the Denial Management System of the Utilization Management Department. Interview and hire applicants for employment into available job positions in the Utilization Management Department as well as supervise and conduct the orientation of new employees. Review, edit, co...

Informs member and provider of Utilization Management determinations and treatment alternatives. MetroPlusHealth Utilization Management policies, procedures, and protocols. Assists all departments with the resolution of members' problems related to utilization management issues.

Performs all Utilization Management activities in compliance with all regulatory agency requirements. MetroPlusHealth Utilization Management policies, procedures, and protocols. Informs member and provider of Utilization Management determinations and treatment alternatives.

Assists all departments with the resolution of members' problems related to utilization management issues. Performs all Utilization Management activities in compliance with all regulatory agency requirements. MetroPlusHealth Utilization Management policies, procedures, and protocols.

Coordinates with management, subject matter experts, physicians, member representatives, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is appropriate, timely and cost effective. Ensures all records/logs related to decision requests, Notices of Ac...

Assists all departments with the resolution of members' problems related to utilization management issues. Performs all Utilization Management activities in compliance with all regulatory agency requirements. MetroPlusHealth Utilization Management policies, procedures, and protocols.

The Market Medical Director for Utilization Management will support WellMed Medical Management, Inc. WellMed Medical Management's utilization management program. All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

MetroPlusHealth Utilization Management policies, procedures, and protocols. Informs member and provider of Utilization Management determinations and treatment alternatives. Assists all departments with the resolution of members' problems related to utilization management issues.

Familiar with hospital resources, community resources, and/or resource/utilization management. The role integrates and coordinates utilization management, care coordination, discharge planning functions and performance improvement activities for all care managers. The Supervisor, Care Management ...

The Care Manager under the direction of the Vice President of Clinical Services, is primarily responsible for managing both simple and complex medical cases to achieve high-quality patient care outcomes and minimize unnecessary medical expenses, through the coordination of services, both outpatie...

The Director of Case Management & Utilization will be responsible for the strategic direction setting, management, continuous improvement, and maintenance of the Case Management/Utilization. Two (2) years of experience in case management/utilization review/quality improvement leadership position ...

Case Management (Utilization Review).

As a new Director of Utilization Management at VillageCare, you can expect to oversee the utilization review process, collaborate with interdisciplinary teams to optimize patient care, and develop strategies to enhance operational efficiency. To excel as the Director of Utilization Management at ...

Case Management (Utilization Review).

Calling all healthcare rockstars! Are you a RN (Registered Nurse) with experience in Case Management (Utilization Review) If so, you might be the right fit for this travel healthcare position in Bronx, NY.

Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay, promote efficient utilization of resources and ensure that care meets evidence-based practice standards and regulatory/payor requirements and follows th...

We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. CVS Health also offers numerous well-being programs, education ...

Care Management, Care Coordinator, Utilization Management. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay, promote efficient utilization of resources and ensure that care meets evidence-based practice...

The Director of Utilization and Case Management will spearhead the strategic direction, management, continuous improvement, and overall maintenance of the Utilization and Case Management Services Unit. Lead the Utilization and Case Management Department at University Hospital, a prestigious healt...

The Care Manager will assist the provider in directing care to the most appropriate setting, evaluating alternative care plans, and assessing outcomes through outreach to the members. The Care Manager under the direction of the Vice President of Clinical Services, is primarily responsible for man...

We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. We're hiring a Senior Analyst to join our Utilization Management Design & Configuration team. Oscar is the first health insurance company built around a full stack technology platform ...