- Northwell Health (Melville, NY)
- …plus specialized certifications as needed. Preferred Skills 3-5 years experience in Utilization Review , Case Management, and Clinical Appeals. 3-5 years of acute ... and billing status and ensures compliance with the Utilization Review standard and regulations. Performs concurrent and retrospective utilization management… more
- Sunrise Senior Living (Staten Island, NY)
- …changes in condition and take appropriate action including communication to family. + Review clinical alerts to document and learn about pertinent information ... the Resident Care Director (RCD) to ensure that the residents clinical needs are addressed. + Review , prior to move-in, the resident's preferences and needs and… more
- Mount Sinai Health System (New York, NY)
- …4. Conducts Root Cause Analysis investigations, which includes assessing need for focused review by departments, and or clinical chairpersons for peer reviews. ... **Job Description** The Clinical Risk Manager in the Department of Risk...to the reported incident (s). 7. Facilitates the peer review process and completion of safety solutions. 8. Identifies… more
- Datavant (Albany, NY)
- …product vision, strategy, and roadmap for the Prospective Suspecting and Concurrent Review solutions within Datavant's Clinical Insights Platform suite. + Define ... in working with provider documentation teams, coders, or concurrent review vendors. + Clinical experience or deep...teams, coders, or concurrent review vendors. + Clinical experience or deep engagement with clinician stakeholders. +… more
- Aspen Dental (Holbrook, NY)
- …the direction of the Manager, supervise and reinforce the daily tasks and priorities of the non- clinical team + Review data day to day to evaluate the impact on ... patient care + Consult with patients on treatment options provided by clinical team, verifying insurance payment and collection ensuring high quality of care… more
- Whitney Young Health Center (Albany, NY)
- …as appropriate, and as required by acuity level. + Participates in weekly HIV/HCV/PrEP Clinical Care Review + Assist clients to access programs that will help ... The CPTS Care Coordinator participates in multidisciplinary team meetings in partnership with clinical staff to discuss patient needs on a weekly basis. The role of… more
- Compass Group, North America (New York, NY)
- …of required departmental audits as indicated by leadership team, which may include clinical documentation review , food safety and sanitation, meal accuracy, and ... a valid CDR # **Position Details** : + Provides clinical support to regional accounts + Role requires extensive...standards; is the leader in communicating and implementing new clinical systems and programs, both with clients and Dining… more
- Saratoga Hospital (Saratoga Springs, NY)
- …interventional CT procedures, ensuring seamless setup and collaboration with radiologists and clinical staff. + Review imaging orders, assess image quality, and ... part in diagnostic services, ensuring accurate imaging that directly supports critical clinical decisions. If you thrive in a fast-paced healthcare setting, value… more
- STG International (West Seneca, NY)
- …* Design and participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... ensure continuous effective operations of the CBOC and participate in the Clinical Quality Assurance Program. ESSENTIAL FUNCTIONS: * Provide vision and direction of… more
- STG International (Kingston, NY)
- …+ Design and participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... continuous effective operations of the CBOC and participate in the In the Clinical Quality Assurance Program. ESSENTIAL FUNCTIONS: + Provide vision and direction of … more