- Highmark Health (Albany, NY)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most… more
- Nuvance Health (Carmel, NY)
- …essential services a community needs from their local hospital, including Emergency and Behavioral Health Services. Our accolades include: * The Leapfrog Group - ... *Description* *Intro:* At Nuvance Health , we enjoy the benefits of a two-state...Program (MBSAQIP) * Robotic Center of Excellence - Surgical Review Corporation (SRC) At Putnam Hospital, our team members… more
- Highmark Health (Albany, NY)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
- Highmark Health (Albany, NY)
- …+ Participate in product specific Pharmacy and Therapeutics Committees and Drug Utilization Review (DUR) Committees as necessary or contractually required. + ... position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of...with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as… more
- Mount Sinai Health System (New York, NY)
- …approach to collaborate with other health care professionals to plan, monitor, review , and evaluate the cost, utilization , safety and effectiveness of drugs ... policies, and other programs. Serves as a clinical pharmacy resource for the health system and its affiliated pharmacy services. Responsible to serve as a preceptor… more
- Whitney Young Health Center (Albany, NY)
- …the following populations: persons with HIV/AIDS, Hepatitis C, Substance Use and/or Behavioral Health Conditions. Strong written and verbal communication skills; ... Be a part of the mission at Whitney Young Health (WYH) to provide high quality healthcare that is...acuity level. + Participates in weekly HIV/HCV/PrEP Clinical Care Review + Assist clients to access programs that will… more
- Catholic Health Services (Freeport, NY)
- …counseling, intervention, and continuity of care to individuals with mental health disorders, emotional disorders and other behavioral challenges. Participates ... and nursing excellence, Mercy Hospital, a member of Catholic Health , may be what you are seeking. We offer... problems and/or emotional disorders of individuals. + Provides review and evaluation of dually diagnosed individuals during pre-admission… more
- Highmark Health (Albany, NY)
- …effective application of appropriate design standards, methods, and tools. + Review application designs to ensure optimal technology selection, efficient resource ... utilization , and seamless system integration. + Ensure system architecture...automation scripts (Shell, Python) for streamlining tasks, ensuring peer review and version control. + Maintain comprehensive technical documentation,… more
- Rochester Regional Health (Rochester, NY)
- …for quality initiatives, collaborates with CNO/Director of Quality to provide quality review activities. Guides assigned areas in utilization of recognized ... Job Title: Manager, Acute Services InpatientDepartment: Operations- Behavioral HealthLocation: Clifton Springs Hospital Hours Per Week: Full-Time, 40… more
- FLACRA (Penn Yan, NY)
- …within the timelines outlined by FLACRA. + Participates in quality initiatives and utilization review activities as requested. + Strives to understand and meet ... diverse persons, staff and community service providers. + Knowledge of local behavioral health service system. + Ability to multi-task, have good problem solving… more