Overview Plans and implements population/disease management programs and related protocols/policies based... covered services and utilization of the Key Provisions of the Affordable Care Act for Children. Collaborates with management...
and updates through on-going training, coaching and educational materials. For Utilization Management Only: Issues... or federal regulations are saved in the Utilization Management System. Reviews, evaluates and determines the appropriateness...
+ years of utilization management experience Strong knowledge of utilization management processes and industry best practice... clinical and operational management services and market expansion initiatives for Managed Medicaid, Medicare Advantage, Special...
Under the supervision of the Senior Director of Integrated Care Management (ICM), the Director of ICM (Medicare... for managing the day-to-day operations of the clinical and non-clinical staff, ensuring adherence to the care management process...
team and in accordance with approved protocols, provides high quality patient care, Diabetes Self-Management Education..., assessing and identifying risk factors, negotiating care plans with the patient, education (group and/or individual), monitoring...
team and in accordance with approved protocols, provides high quality patient care, Diabetes Self-Management Education..., assessing and identifying risk factors, negotiating care plans with the patient, education (group and/or individual), monitoring...
team and in accordance with approved protocols, provides high quality patient care, Diabetes Self-Management Education..., assessing and identifying risk factors, negotiating care plans with the patient, education (group and/or individual), monitoring...
management and helping address health-related social needs. Founded in 1999, Essen provides care in all five boroughs of New... with community organizations and agencies and health plans. Essen is dedicated to ensuring the quality of care for all patients...
and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients... Graduate of an accredited nursing program, Bachelor’s preferred Knowledge with Utilization management processes preferred...
and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients... Graduate of an accredited nursing program, Bachelor’s preferred Knowledge with Utilization management processes preferred...
or social work practice in clinical settings required. Previous managed care experience in the areas of utilization management... and/or case management preferred. Minimum 1–3 years of previous management experience preferred. NYS RN license and registration...
and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients... Graduate of an accredited nursing program, Bachelor’s preferred Knowledge with Utilization management processes preferred...
hospitalization Performs concurrent utilization management using evidence based medical necessity criteria Submits data...Job Category: Care Management and Social Work Services Job Description: Registered Nurse Case Manager - FlexStaff...
management initiatives. Collaborates with the Clinical Coordinator/Charge RN or Nurse Supervisor to ensure the aggressive.... Collaborates closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse...
benefits: Including health, dental and vision insurance, retirement plans, employee assistance programming and more. POSITION... is made up of 14 federally qualified health centers throughout Brooklyn, the Bronx, Queens, and Manhattan, along with a fleet...
. Ongoing Monitoring: Track changes in member health status and adjust care plans to promote independence and quality of life... in geriatrics, managed long-term care, or care management strongly preferred. Technical Skills: Proficient in electronic health...
. Ongoing Monitoring: Track changes in member health status and adjust care plans to promote independence and quality of life...Job Overview Bilingual RN Nurse Care Manager (Managed Long Term Care): Compensation: $110,000 $115,000/year...
on-going training, coaching and educational materials. • For Care Management Only: • Assesses, plans, facilitates and advocates... analysis of initial health evaluation and comprehensive assessment of the member/family psychosocial status and case management...
Health Plans product lines – Managed Long Term Care (MLTC), Medicare Advantage (MA) or Select Health. Ensures compliance..., investigation and resolution of member grievances and appeals for one of the following VNS Health Plans product lines - Managed Long...
and updates through on-going training, coaching and educational materials. For Care Management Only: Assesses, plans...Overview: Assesses member needs and identifies solutions that promote high quality and cost-effective health care...