- WMCHealth (Valhalla, NY)
- … experience in a hospital setting, preferably cardiology, radiology, surgery or utilization review , required. Previous revenue integrity experience, Excel and ... departments. + Identify pre-bill and post-bill claim edits involving any type of clinical or coding review or required modifier based on services rendered.… more
- Bassett Healthcare (Cooperstown, NY)
- …Efficiently places each patient and verifies he/she is in the appropriate level of care and correct patient status/type. Uses clinical knowledge to plan and ... healthcare team to improve LOS performance of the Bassett Healthcare Network. This clinical position works in conjunction with the physician and/or staff and has the… more
- Sunrise Senior Living (Mount Vernon, NY)
- …business needs. + Possess functional knowledge of all operating programs including memory care , clinical , dining, and social programs. + Make accurate forecasts. ... in setting standards of excellence; we strive to provide care and services to seniors better than anyone. The...achieving customer engagement. + Lead the development and regular review of the engagement improvement plan. + Resolve customer… more
- WMCHealth (Kingston, NY)
- …that performs a functional evaluation of the client; conducts the planning and utilization of a program of purposeful activities; implements the development and ... utilization of a treatment program, and/or consultation with the...referral of a physician, nurse practitioner or other health care provider acting within his or her scope of… more
- Molina Healthcare (Yonkers, NY)
- …and expertise in the performance of prior authorization, inpatient concurrent review , discharge planning, case management and interdisciplinary care team ... + Develops medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** **REQUIRED EDUCATION:** * Doctorate Degree in...+ 10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/Managed Care … more
- City of New York (New York, NY)
- …level of functioning and self-sufficiency by providing comprehensive, integrated, individualized clinical and support services. CAS works with other programs at HRA ... Practitioner who wlll: 1. Obtain referrals and schedule for evaluations from the Clinical Intake Unit for assignment of cases. Coordinate time and place of… more
- Stony Brook University (Commack, NY)
- …and Quality Assurance:** + Manage the PBM services provided by the Long Island Clinical Center of Excellence. + Support and guide pharmacy work performed by care ... proper and complete documentation. Ensure appropriate decision-making at the care coordinator level and excellent customer service. Ensure standard protocols… more
- UHS (Norwich, NY)
- …practice as a GN Preferred: + Bachelor of Science degree in Nursing + Previous clinical nursing experience in an acute care or ambulatory setting + Professional ... of individuals and families. In this role, you will provide patient-centered care by preventing illness and injury, alleviating suffering, and advocating for your… more
- Evolent (Albany, NY)
- …to adeptly negotiate internally and externally around interpretation and application of utilization review law, accreditation standards and policy. + Ensures ... initiatives. **What You Will Be Doing:** + Responsible for oversight of utilization management (UM)/ care management (CM) correspondence development, internal and… more
- Catholic Health Services (Freeport, NY)
- …for retirement and PTO plan. Join us and Long Live Long Island where we care for Every Patient, Every Time. Explore a career with Mercy Hospital, a 375-bed ... Stroke Center, Breast Imaging Center of Excellence, Level III Neonatal Intensive Care Unit, and has received Pathway to Excellence designation from the American… more