- Excellus BlueCross BlueShield (Rochester, NY)
- …of the SIU Management, this position is responsible for the accurate and thorough clinical investigation of potential fraud, waste and abuse (FWA) for all lines of ... substantiating referrals, case planning and research, conducting onsite or desk audits, clinical reviews of medical records to ensure correct billing of services and… more
- Mount Sinai Health System (New York, NY)
- …7. Monitors institutional information technology infrastructure and corrects gaps in clinical nurse documentation . 8. Leads staff participation in quality ... of Nursing is responsible for the overall strategic planning for all clinical programs to ensure implementation of the mission, philosophy, patient care standards… more
- Trinity Health (Syracuse, NY)
- …interdisciplinary team including ortho, bariatric & neurosurgery physicians & clinical affiliates, rehab services, pharmacy and nutritional services. + ... **Professional Development:** Strong education program, generous tuition allowance and clinical ladder incentives. We encourage job share opportunities to enhance… more
- Mount Sinai Health System (Long Island City, NY)
- …7.Monitors institutional information technology infrastructure and corrects gaps in clinical nurse documentation . 8.Leads staff participation in quality ... is a Registered Professional Nurse with broad knowledge and skills who acts as clinical leader in the daily functioning of the unit and oversight of quality patient… more
- Evolent (Albany, NY)
- …leaders, and clinical professionals. + A role that values innovation, continuous improvement , and clinical excellence. + **This position is 100% Remote and ... Are you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular… more
- Catholic Health Services (Melville, NY)
- …agencies, as needed or requested. + Handles queries from payors for additional clinical documentation . + Acts as liaison between the Utilization and Appeals ... Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and appeals according to industry accepted clinical … more
- WMCHealth (Kingston, NY)
- …program director in a timely, appropriate manner. + Refers any repetitive physician/resident clinical or documentation outliers to the stroke program peer review ... patients. + Collects and analyzes benchmarking data, focus studies, and clinical indicators. Provides education, ensures loop closure, prepares reports, presents… more
- New York State Civil Service (NY)
- …for data base in a timely manner. * Completes required medication error documentation and staff medication error remediation. Provides clinical supervision to ... and complete review of items. * Interacts with primary, medical specialists, various clinical staff as necessary. * Advocate for individuals' health care needs. *… more
- New York State Civil Service (Queens Village, NY)
- …for data base in a timely manner. * Completes required medication error documentation and staff medication error remediation. *Provides clinical supervision to ... and complete review of items. * Interacts with primary, medical specialists, various clinical staff as necessary. * Advocate for individuals' health care needs. *… more
- WMCHealth (Poughkeepsie, NY)
- …understanding and assists patients to establish realistic expectations. + Meets all documentation requirements + Completes clinical documentation in a ... and reimbursement authorities. + Accurately completes and submits required non- clinical documentation , including billing, scheduling, coverage/hand-off information,… more