- Humana (Albany, NY)
- …to medical directors and leadership during Medicare and Medicaid LOB - Medicare Clinical Criteria Review (MCCR), Utilization Management Committee (UMC), ... societies + Please note this role will consist of working mostly independently to review at times large amount of clinical information to update clinical… more
- 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, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the...or Public Health **EXPERIENCE** **Required** + 5 years in Clinical , Direct Patient care (hospital, outpatient, or… more
- Molina Healthcare (NY)
- …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care , ... staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
- Fresenius Medical Center (Bayside, NY)
- **About this role:** As a Clinical Manager with Fresenius Medical Care , you will ensure that quality patient care is delivered while maintaining clinical ... will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing end stage renal… more
- Touro University (Hawthorne, NY)
- …clinical practice, each student's performance related to: + Quality and quantity of clinical care . + Each student's practice and patient resources. + Each ... case of the community practices, aid in the continual review of student rosters. + In the case of...of the clinical practices, arrive prior to clinical start, provide guidance and direction in care… more
- Fresenius Medical Center (New York, NY)
- …of their clinical and operational processes to impact patient centered care resulting in improved patient outcomes and satisfaction and decreased morbidity and ... Advisory Board Recommended Algorithms and Standing Orders, clinical pathways and clinical policies and procedures to improve care coordination and care… more
- University of Rochester (Brighton, NY)
- …and involvement with the legal system, who are not engaging in traditional outpatient clinical care . Oversees all administrative and clinical matters on the ... the community, fostering referrals, and assumes teaching and direct clinical care responsibilities. The team provides most...Work with Strong Ties leadership and Dept of Psychiatry Utilization Review team to address documentations concerns… more
- Boehringer Ingelheim (New York, NY)
- …This may include: prescribing and non-prescribing healthcare stakeholders, patients, care partners, consumers, community organizations, and advocacy partners. Works ... including disease state and management tools, healthcare provider resources, patient, care partner, community advocates, and consumer education materials and product… more
- Bassett Healthcare (Cooperstown, NY)
- …programs. The Clinical Pharmacy provides education and information on pharmaceutical care and drug therapy as directed and/or mentored by a licensed pharmacist. ... best quality of life possible. What you'll do The Clinical Pharmacy Intern will work Per Diem, Various Shifts...use issues in collaboration with the medical staff, pharmaceutical care services staff, and/or any other appropriate staff member(s).… more
- Molina Healthcare (Rochester, NY)
- …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care , ... staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more