CARE MANAGEMENT ANALYST CMO

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Yonkers, NY

JOB DETAILS
SKILLS
Analysis Skills, Case Management, Certified Medical Assistant, Clinical Data Collection, Clinical Information Systems, Copying Machines, Data Entry, Fax Machines, Healthcare, Healthcare Management, Healthcare Software, Hematology, Information Technology & Information Systems, License Management, Licensed Practical Nurse/Licensed Vocational Nurse, Managed Care, Medical Record System, Medications, Microsoft Management Console (MMC), Microsoft Office, Oncology, Operations Management, Operations Processes, Palliative Care, Patient Care Authorizations, Process Management, Training/Teaching, Typing, Utilization Management
LOCATION
Yonkers, NY
POSTED
1 day ago

IntroductionTo heal, to teach, to discover and to advance the health of the communities we serve.To learn more about the “Montefiore Difference” – who we are at Montefiore and all that we have to offer our associates, please click here.OverviewWorking under the supervision of a licensed/certified clinical professional, the Care Management Analyst (CMA) is responsible for managing operational processes for care management programs that include, but are not limited to complex care, chronic care, palliative care, and care transitions programs.ResponsibilitiesThe CMA collects and organizes information from multiple sources including members, caregivers, physicians, clinical information systems and electronic health records.The CMA uses this information to make decisions regarding the appropriateness of utilization and benefit application for specific health care services and/or directs this information to appropriate staff for intervention/follow-up in accordance with established organizational and/or departmental protocols, policies and procedures.The CMA may assume responsibility for managing the above activities for a case load of members or may manage specific processes and tasks related to case management and utilization management activities.The CMA interfaces with and acts as a resource to team members, other MMC and CMO departments, members/caregivers and physicians/care providers.RequirementsAssociate Degree required, Master's Degree preferred.LPN (Licensed Practical Nurse, with valid NYS registration).2 years' experience.Preferred experience in Hematology/Oncology and Medication prior authorization.Medical Management experience in a managed health care setting preferred.Appropriate training and experience in case management preferred.Equipment Operation:MS Office, email, internet.Experience working within case/utilization management systems, data entry and typing.Automatic phone distribution systems.Electronic fax systems.Copier/scanning machine.Familiarity with web-based information systems.#J-18808-Ljbffr

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