- Datavant (Albany, NY)
- …For: The Support Specialist position is responsible for working within the Price Review production queue to ensure requests are accurately processed to the correct ... from these requirements will be reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in which you will be working,… more
- Molina Healthcare (Rochester, NY)
- …set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, ... responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and… more
- Centene Corporation (New York, NY)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all ... requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care… more
- Global Foundries (Malta, NY)
- …+ Hosting regular meetings with cross-functional teams. + Governing delegated review boards, ensuring compliance with quality standards and defining customer ... and tracking efficiency and effectiveness through KPIs. + Managing escalation review boards with senior leadership team. + Leading continual improvement activities… more
- Guthrie (Binghamton, NY)
- Provides health care services regarding admissions, case management, discharge planning and utilization review . Responsibilites: Reviews admissions and service ... medical necessity and/or compliance with reimburesement policy criteria. Provides case management and/or consultation for complex cases. Assists departmental staff… more
- Deloitte (New York, NY)
- Senior Consultant - National Federal Tax Services - Strategic Tax Review (STR) Do you have excellent tax compliance skills and a strong desire to join a cutting-edge ... up of multiple tax service offerings including Strategic Tax Review , Inventory Tax Services, and Meals & Entertainment ...are dependent on the facts and circumstances of each case . A reasonable estimate of the current range is… more
- City of New York (New York, NY)
- …processed by Medicaid Settlement Unit staff by randomly selecting a set percentage of each Case Reviewer 's completed cases. Review case files and data ... judges and insurance companies regarding liens associated with their clients. Review all case lien information and provide a written or verbal response to… more
- Evolent (Albany, NY)
- …for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a meaningful impact ... interventional cardiology to help ensure the delivery of high-value, evidence-based case reviews. Enjoy improved work-life balance while contributing to better… more
- M&T Bank (Amherst, NY)
- …debtor(s), restrains accounts as appropriate by applying proper exemptions and preparing case file as appropriate. Processes complex legal papers, such as court ... orders and temporary restraining orders. **Primary Responsibilities:** + Monitor work flow and serve as liaison between assigned Item Processing & Deposit Services unit and management. + Provide training and coaching to assigned Item Processing & Deposit… more
- City of New York (New York, NY)
- …in the Tax Audit and Enforcement Division. The selected candidate will manage the Audit Case Analysis & Reporting (ACAR) and the Review & Quality Control (RQC) ... but are not limited to, the following: -Oversee monthly review of each reviewer 's completed assignments to...tax related auditing or tax accounting experience. In all case , all candidates must have at least 18 months… more