- Mount Sinai Health System (New York, NY)
- …Masters preferred. **Experience Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or ... plan of care and coordination of services based on clinical needs and available resources. + Utilization Review : a. Maintains a working knowledge of the… more
- Northwell Health (Staten Island, NY)
- …management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care /discharge planning, preferred. + ... to the health care team regarding quality, utilization of clinical resources, payer, and reimbursement...utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of… more
- Touro University (Hawthorne, NY)
- …opportunities, including emergencies and backfill patients into student provider open slots, review phone call and utilization reports to aid in optimal ... Overview The Patient Care Coordinator in working as part of a...the Senior Treatment Plan Coordinator and indirectly to the Clinical Practice Leader; This position strives to make each… more
- Centene Corporation (New York, NY)
- …physician education with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends in utilization of ... management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... Care Manager - Per Diem **Position Summary** At...is a valuable member of our team, who provides clinical services to our patient population. Qualified candidates will… more
- Mount Sinai Health System (New York, NY)
- …Degree in Nursing; Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case ... plan of care and coordination of services based on clinical needs and available resources. 3. Utilization Review : 1. Maintains a working knowledge of the… more
- Bassett Healthcare (Cooperstown, NY)
- …2-3 exceptions, as measured by direct supervisory observation and random supervisory chart review Directs and supervises patient care provided by LPNs and ... life possible. About the department Bassett Medical Center's Special Care Unit is a 24-bed intermediate care ... Unit and Medical Units. Because of the higher clinical needs of the patient's cared for on this… more
- Catholic Health Services (West Islip, NY)
- …Administrative Staff. Ensures compliance with Hospital Conditions of Participation. Implements care management programs, including utilization review , intake ... but not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals, Managed Care and...Evaluates patient care data to ensure that care is provided in accordance with clinical … more
- Mount Sinai Health System (Long Island City, NY)
- …Description** The Director will direct and manage departmental activities involved in utilization review , appeals management and discharge planning to facilitate ... able to navigate through a wide variety of managed care contractual issues. Must have knowledge of and familiarity...services by focusing on patient processes. 8.Develops and implements Utilization Review (UR) based on internal data… more
- Mohawk Valley Health System (Utica, NY)
- …regarding correct level of care and reimbursement. Apply knowledge of utilization review , discharge planning, patient status changes, length of stay, patient ... and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance with regulatory requirements,… more