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Utilization Manager Jobs in Albany

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Search Results - Utilization Manager Jobs in Albany
Humana Inc-Albany-appcast.io-
and recognized clinical standards.  •  Analyze complex hospital-based cases and deliver clear, well-reasoned utilization management determinations.  •  Communicate with external providers via phone to obtain clinical information and discuss review outcomes...
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Albany-enlyte.com-
Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC...
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Humana Inc-Albany-appcast.io-
tools, and utilization management practices. Required Qualifications  •  MD or DO with 5+ years of post‑residency clinical experience , preferably with inpatient exposure (hospitalist‑level acuity, ED, ICU, or hospital‑based FP/IM).  •  Active...
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Latham (NY), 8 mi from Albany-icims.com-
documentation of Utilization Review activities in the case management and pharmacy benefit management systems.  •  Responsible for completing timely reviews according to state’s requirements and communicating the UR determination to all parties.  •  Uses clinical...
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Salem Health Hospitals & Clinics-Albany-appcast.io-
of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non...
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Albany Medical Center-Albany-
and resolution of the barriers to discharge in collaboration with social work, utilization management, home health care, care team and family to facilitate timely discharge.  •  Responsible for follow up post discharge telephone calls to patients/families and post...
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Humana Inc-Albany-appcast.io-
Knowledge of the managed care industry including Medicare, Medicaid and Commercial products  •  Have interpretation skills with prior experience leading teams focusing on quality management, utilization management, discharge planning and home health or rehab...
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Albany Medical Center-Rensselaer (NY), 1 mi from Albany-
and resolution of the barriers to discharge in collaboration with social work, utilization management, home health care, care team and family to facilitate timely discharge.  •  Responsible for follow up post discharge telephone calls to patients/families and post...
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