- Humana (Albany, NY)
- …+ Excellent written and communication skills + 5 years of established, post-residency clinical experience + Knowledge of the managed care industry including ... first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on… more
- Whitney Young Health Center (Albany, NY)
- …+ Working collaboratively with clinical teams, coordinates various aspects of utilization and review and management + Working collaboratively with the human ... Health is responsible for implementation and ongoing monitoring of administrative and clinical systems that support patient care within the assigned practice.… more
- University of Rochester (Rochester, NY)
- …accuracy of patient schedules. Reviews provider schedules to ensure maximum utilization . Negotiates down-payments and authorizes repayment status for high dollar, ... pretreatment estimates and insurance approvals. Acts as a resource to patients and care providers of Medicaid approval process and other 3rd party billing issues.… more
- Kaleida Health (Williamsville, NY)
- …Suite and Outlook. 2 years of experience In any combination of: case management, home care and utilization review preferred. Knowledge of and experience with ... Part-Time **Shift 1** **Job Description** **The supervisor provides leadership to Patient Care Coordinators to support care management and interventions for… more
- Arms Acres (Bronx, NY)
- …as identified in patient treatment plans and requested by program director. Performs utilization review , provides progress reports and develop aftercare plans in ... alcohol or drugs. Sign-on bonus eligible FUNCTION: To provide comprehensive clinical case management services that include: assessments; individual, group and family… more
- BriteLife Recovery (West Kill, NY)
- …of supervisor, establish appropriate therapeutic boundaries, utilization of identified clinical resources to review boundaries, limit setting for behavior, ... facility. The ability to follow the direction of the Clinical Director and BHT Supervisor and safely transport clients...of the clients in the facility and demonstrate exceptional care when transporting clientele. What tasks are required? +… more
- Humana (Albany, NY)
- …with medical terminology and/or ICD-10 codes. + Member service + Experience with Utilization Review and/or Prior Authorization, preferably within a managed ... The Bilingual Telephonic UM Coordinator / UM Administration Coordinator 2 provides non- clinical support for the policies and procedures ensuring best and most… more
- CUNY (Brooklyn, NY)
- …hours necessary for dental hygiene licensure at City Tech on campus in the patient care clinic. The City Tech patient care clinic provides oral health services ... tristate area, and the clinic's focus is on patient care management. All patient care is provided...and end of each semester with paperwork needed for clinical purposes. + Assist clinic coordinators during student registration… more
- Catholic Health Services (Roslyn, NY)
- …and safety and every human moment in between - we're dedicated to providing better care for our communities. Every patient. Every moment. That's what it means to be ... Monitor CT workflow continuously to ensure efficiency and minimize patient wait times Review the CT completed list and identify any unread exams; escalate to… more
- Northern Rivers Family Services (Troy, NY)
- …county and community partners, and participate in any quality audit and utilization review + Provide on-site/community based/home visits, medication evaluations, ... and informal training and education to staff + Prescribe medications, monitor, and review of drug regimen for enrolled individuals + Participate in quality assurance… more