- Centene Corporation (New York, NY)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... overall health and appropriate level of care + Reviews quality and continuity of care by reviewing acuity level,...care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …and leadership to the Global Quality function with responsibilities for Global Clinical Quality (GCQ), CSV and GPV. In this role, the leader oversees ... **Data Integrity:** Ensure the accuracy, consistency, and reliability of clinical and PV data through robust Quality ...Clinical vendor management and vendor oversight. + **Management Review :** Establish and maintain a system to ensure R&D… more
- Molina Healthcare (Buffalo, NY)
- …read team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. + Mentor entry and Sr. level ... as NCQA reviews, CAHPS and state audits by reviewing clinical documentation. + Provides data collection, presentations and report...SKILLS & ABILITIES:** + 5 years experience in healthcare Quality /HEDIS specific to medical record review and… more
- Centene Corporation (New York, NY)
- …provider practice patterns, and adequacy of benefit/payment components. + Identifies clinical quality improvement studies to assist in reducing unwarranted ... leadership of all for utilization management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining… more
- Trinity Health (Syracuse, NY)
- …complete documentation to ensure revenue optimization and integrity. Performs outpatient clinical documentation improvement review (acute only) as needed. ... **Employment Type:** Full time **Shift:** **Description:** Certified Coder Fully remote . May include every 5th weekend rotation **POSITION PURPOSE** Responsible for… more
- Trinity Health (Albany, NY)
- …will be located at 63 Shaker Road, Albany, NY and is available hybrid remote . **Position Highlights:** + ** Quality of Life:** Where career opportunities and ... **RN - Endocrinology Office - Albany, NY / Hybrid Remote - FT** If you are looking for an...directed by provider. + Performs pre-visit planning and reviews quality metrics. + Retrieves telephonic clinical information… more
- Merck (Albany, NY)
- …content review and approval for IND/CSA submissions to enable clinical trial initiation. + Participate in regulatory due diligence activities for in-licensing ... the preparation, submission, and follow-up of regulatory applications and ensure quality and compliance across all documentation. + Interact independently with… more
- HCR Home Care (Rochester, NY)
- …all Agency policies and procedures and follow the Employee Handbook Guidelines . + Quality : + Audit clinical records to identify trends/areas of improvement in ... daily support to field clinicians enabling them to provide quality care in the home to HCR patients. Th...Clinical assistance : + Triage incoming calls. + Audit/ Review DRRs . + Other duties as assigned. This… more
- Mount Sinai Health System (New York, NY)
- …Sinai Hospital **Responsibilities** **New Charge Requests & Clinical Documentation Review :** + Review clinical documentation to validate appropriate ... **Job Description** **Senior Financial Analyst/CDM Chargemaster -Corporate-Full-Time Days ( REMOTE )** We seek an experienced Senior Financial Analyst / CDM… more
- WMCHealth (Valhalla, NY)
- … or monitored settings. + Oversees centralized transfer processes, including participation in clinical review of cases as necessary to ensure timely and safe ... + Foster a culture of teamwork, continuous improvement, and quality care across the network. + Oversee the coordination...for patients in need of constant observation or in remote locations. + Collaborate with clinical teams… more