- Datavant (Albany, NY)
- …We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a standardized system, ensuring ... and or auditors + Participate in weekly coding project review meetings + Any other tasks asked by quality...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- Datavant (Albany, NY)
- …in the RAB-ROI Advisory Board and support the meeting build, minute review , presentation and follow up project management to ensure standardization and reduction ... of variation in processes across the enterprise. + Review , assess and provide resolution to all negative and...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- City of New York (New York, NY)
- …requests for action, and/or complaints brought to its attention. - Perform necessary case review , takes any necessary action in HRA OneViewer, Fair Hearing ... for investigating the issue, determining the appropriate response, conduct any necessary case actions (including the issuance of benefits, addition of a new … more
- New York State Civil Service (Sherrill, NY)
- …are not compliance based. This requires analytical skills, a strong interview skill set, review of case records and documentation and other methodologies in a ... assist with quality improvement projects, to assist with the review of recommendations of quality management plans, assist with...may include but not be limited to: - Conduct case reviews and person-centered reviews in accordance with policies,… more
- Sedgwick (Albany, NY)
- …client satisfaction; to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple ... business lines; and to provide expertise in client specific case management and utilization review requirements and ensure customer satisfaction through the… more
- Datavant (Albany, NY)
- …understanding of complications, co-morbidities, severity of illness, risk of mortality, case mix index, secondary diagnoses, and procedure impact on DRG. + ... 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
- United Therapeutics (Albany, NY)
- …a SME on evaluating and ensuring appropriate quality standards and adherence to case processing procedures. You are passionate about PV and enjoy partnering with ... The Lead Pharmacovigilance QC Specialist provides strategic oversight of end-to-end case safety quality, ensuring compliance, and quality in adverse effects,… more
- City of New York (New York, NY)
- …Hearings in an effort to defend and resolve disputes on public assistance case actions that assist in moving participants toward economic independence by presenting ... State Administrative Law Judges with a complete and relevant case record and supporting documents to justify the challenged...the sites for follow-up actions to be initiated. - Review Fair Hearing decisions and recommend actions to challenge… more
- Ellis Medicine (Schenectady, NY)
- …and evaluate individual healthcare needs. Integrate Discharge Planning, Utilization Review and Performance Improvement activities at the patient, hospital and ... and effectively anticipates, identifies and resolves issues through utilization review and discharge planning processes. Collaborates with the ED physicians… more
- City of New York (New York, NY)
- …packages and other notices to ensure parties have been informed of scheduled hearings. - Review child support case files and forward to OLA in advance of ... the Agency in support of the child support hearing. - Review Court Outcome Disposition sheets and case files after the hearing is completed to determine the… more