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Collaborate with other organizational departments responsible for functional aspects of the HIV Special Needs Plan, including, but not limited to Integrated Care Management, Behavioral Health, Managed Long-Term Care, Utilization Management, Quality Management, Credentialing, Regulatory Affairs, Compliance, Corporate Affairs, Provider Network Operations, Medicare Services, Information Systems, Finance, Claims, and Member Services and Eligibility.
$157,236 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Integrates and coordinates utilization management, care facilitation and discharge planning functions. Certified Case Manager (CCM), Certified Clinical Medical Assistant (CCMA), or American Case Management Association (ACMA) certification strongly preferred.
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The Workers' Compensation Nurse Case Reviewer collaborates with medical care providers, employers, employees, and at times, attorneys to support the appropriate return to work, the provision of necessary medical services, and the evaluation of coverage under the Plan. The Nurse Case Reviewer reports to the Casualty Department Manager.
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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.
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As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Health network includes over 27,000 primary care providers, specialists and participating clinics.
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VNS Health is seeking a per diem / prn nurse RN Case Management for a per diem / prn nursing job in Manhattan, New York. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Per Diem Provides telephonic clinical care management services using evidence-based practices to ensure effective utilization of benefits, services, and care is provided to the patients allowing them to remain safely in their home/community.
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Monitor care management activities, services, and members' responses to interventions to determine the effectiveness of the plan of care and the utilization of services and implements changes and adjustments to meet needs and goals.
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Drive market-level projects to optimize quality, risk adjustment, utilization management, financial performance, and membership growth. Strong background in managed care, preferably with experience in network management and value-based roles.
$161,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Interact with insurance companies for pre-certification and utilization management. Provides safe, empathetic, and affirming care for each client and their unique circumstance based on the clients' intersecting identities.
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Coordinates with the Clinical Coordinator/Clinical Nurse Manager/Assistant Nurse Manager/Nursing Shift Manager to ensure supplies are appropriately utilized and inventory is sufficient for patient care.
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The ideal candidate will leverage expertise in high-level complex SaaS sales in supply chain risk, vendor risk management, and/or third-party risk management. Familiarity with Supply Chain Risk Management, Governance, Risk & Compliance, and Third-Party Risk Management.
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Primary duties of the Trash Collector include: - Operating garbage trucks - Collecting and dumping trash receptacles - Following route assignments as directed Waste Management offers an excellent benefits package that includes medical, dental, vision, life, 401(k) savings and more.
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Assesses and evaluates patient care needs and applies critical thinking skills in patient care management. Critical Care - Mount Sinai Hospital Summary: The Clinical Nurse is a Registered Professional Nurse who provides safe, competent quality care based on nursing theory and research to a designated group of patients and significant others.
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Submit your application now to become a Trash Collector with Waste Management! Waste Management is currently accepting applications for a Trash Collector! Submit your application now to become a Trash Collector with Waste Management.
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Has a 24-hour responsibility for the supervision, scheduling, hiring, firing and performance appraisal of nursing and ancillary associates within their Surgical specialties but not limited for the Operating Room. Coordinates other activities including but not limited to inventory management, budgeting, and performance improvement activities to promote efficient/effective operations and quality patient care.
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utilization management care manager jobs Company: Metroplus Health Plan in Brooklyn, NY
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