- Healthfirst (NY)
- …and Responsibilities:** + Conduct outreaches for newly enrolled members to review current and approved services, durable medical equipment (DME) and additional ... requests + Review intake documents for pre-approved services and escalate discrepancies...and identify any issues or risk factors that require clinical escalations to a CM/PCM. + Initiate and finalize… more
- Northwell Health (Staten Island, NY)
- …patient's compliance. + Participates in quality meetings to discuss cases and review clinical outcomes. + Meets the educational needs of families and other ... a resource person to the health care team. Job Responsibility + Reviews all protocols to maintain quality control and patient safety, and to assist Physicians with… more
- SUNY Upstate Medical University (Syracuse, NY)
- …the ED when possible. Updating patient (if indicated) with revised financial estimate. Quality assurance and training, resolving ED Missing Reg Items work queues and ... to ensure smooth and efficient patient flow. Liaison to clinical staff when supervisor is not available. Maintain good...and/or attending, inpatient bed swaps and transfers. Death certificates: review autopsy form to determine if the body can… more
- Molina Healthcare (Albany, NY)
- …Association** Any one or more of the following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and...Long-Term Services & Supports issues. + Identifies and reports quality of care issues. + Prepares and presents cases… more
- WMCHealth (Valhalla, NY)
- …remote or monitored settings. + Oversees centralized transfer processes, including participation in clinical review of cases as necessary to ensure timely and ... Director, Clinical Logistics Company: WMC Advanced Physician Services PC...+ Foster a culture of teamwork, continuous improvement, and quality care across the network. + Oversee the coordination… more
- Elevance Health (Latham, NY)
- …state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years ... Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement… more
- Whitney Young Health Center (Albany, NY)
- …Prevention and Treatment Services program (CPTS) for NCQA PCMH principles. + Leads program clinical quality improvement activities and serves as SME for the ... together determines an appropriate plan of care. + Develops, reviews, and approves clinical protocols and best practice guidelines. Quality of Service: +… more
- Stony Brook University (Stony Brook, NY)
- …in the areas of clinical pathology, immunology, oncology/tumor markers, and/or clinical laboratory quality . + Minimum 1-2 years teaching experience in ... at Stony Brook University's Renaissance School of Medicine (RSOM) is seeking clinical pathologist (MD) or clinical laboratory scientist (Ph.D.) to serve… more
- Stony Brook University (Stony Brook, NY)
- …specializing in Diabetes program management and development, research experience, and quality assurance experience. + Knowledge of current clinical guidelines ... Clinical Educator **Position Summary** At Stony Brook Medicine,...of certification + Collaborates with the Program Coordinator in review and assessment of program resources. + Collaborates with… more
- Mount Sinai Health System (New York, NY)
- …Other responsibilities include performing cross-functional duties including those of a pharmacist, clinical specialist or other clinical coordinator, as ... **Job Description** Responsible for supporting clinical trial research conducted on various campuses. The...collaborate with other health care professionals to plan, monitor, review , and evaluate the cost, utilization, safety and effectiveness… more