Utilization management jobs in New York, NY - Page 3Create job alerts

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 114,000...

Masters Degree in Nursing Administration, Education, Clinical Specialty or equivalent field and five years of satisfactory nursing experience, of which three years shall have been in a supervisory or teaching capacity; or a Baccalaureate Degree in Nursing and six years of satisfactory nursing exp...

Utilization Management, Prior Authorization – Medical Surgical (Inpatient or Outpatient), Complex Case Management w/ exposure to UM, Concurrent or Retrospective Medical Policy Review. The ideal candidate will have strong analytical skills and the ability to critically review medical files to dete...

The Retail Client Success Manager is responsible for overseeing all facets of client utilization of the Skai™ management platform. Assist Client Success Directors in driving client retention, and identifying business growth opportunities. High level of comfort in deriving actionable insights from...

The Medical Director is responsible for assisting in ensuring appropriate health care utilization management (UM). The Medical Director serves as a physician and policy advisor to the Plan’s Chief Medical Officer. The Medical Director can be a fully remote position.

Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experi...

The Department of Care Management at SUNY Downstate Health Sciences University is seeking a full-time Utilization Review Nurse / TH Utilization Review/Quality Assurance Senior Coordinator (Nights). SUNY Downstate Health Sciences University is an affirmative action, equal opportunity employer and ...

Minimum one to three years' previous management experience preferred. Previous managed care experience in the areas of utilization management and/or case management preferred. When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generou...

Ensures all records/logs related to decision requests, Notices of Action, and other communications required by state or federal regulations are saved in the Utilization Management System. For Utilization Management Only:. Coordinates with management, subject matter experts, physicians, member rep...

The SEM Client Success Manager is responsible for overseeing all facets of client utilization of the Skai™ Search SEM management platform. Partner with Skai™ Client Success Directors to actively build relationships with client partners. Ability to perform detailed client audits to identify clien

The SEM Client Success Manager is responsible for overseeing all facets of client utilization of the Skai™ Search SEM management platform. To collaborate with Local and Social client success teams. Energized by solving problems and finding opportunities to make clients successful.

Assistant Residential Director - Parrish. The Associate Director is responsible for assisting the Senior Shelter Director with the day-to-day operations of the shelter program. Assist Senior Shelter Director with management and oversight of billing process including reaching expected utilization ...

MetroPlusHealth Utilization Management policies, procedures, and protocols. Oversee the coordination and delivery of comprehensive, quality healthcare and services for all members requiring care management in a cost-effective manner. Informs member and provider of Utilization Management determina...

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. Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not...

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. Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not...

As a Behavioral Health Care Advocate you will be responsible for case management and utilization review of behavioral health and substance abuse cases. What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. At Un...

Experience utilizing a Macbook and working in a remote environment (including setting up work station, being on VPN, etc.) * Ability to critically think and troubleshoot issues on their own. Day to ...

Participates in weekly finance meetings, providing insights into project performance, monthly forecasting and resource utilization. Team & Relationship Management: * Cultivates strong relationships ...

Job Title: Registered Nurse (RN) Job Specialty: Telemetry Job Duration: 13 weeks Shift: 7:00 PM - 7:30 AM (3x12 hours, plus an additional 4th shift required per month, including every other weekend) Guaranteed Hours: 34.50 hours per week Experience: Minimum 2 years of tele...

ARMStaffing is looking for RN - Case Management in Bronx, New York.Shift: 8 Hour Day, 07:00:00-15:00:00, 8.Unit Details: Case Management - B06932 Management (Utilization Review).At ARMStaffing we take care of our nurses! We offer:.Health & Retirement Benefits.Day-1 access to extensive benefits

... management, memory/CPU utilization analysis. * • Preferred experience in integration with Big data technologies like Spark and Hadoop Desired Skills and Experience we are Looking For: · Experience ...

Prepare reports and statistical information for both CAMBA management and funder use. * Assist in ... Ensure staff utilization of electronic database and conduct oversight to ensure data integrity

Creating and refining automated lifecycle journeys and one-off campaigns across email, push, SMS, and other CRM channels to increase conversion, utilization, and retention. * Developing and ...

This person will be responsible for supporting the development and management of products from ... seamless adoption and utilization of these technologies. * Take a hands-on approach to ...