- Nuvance Health (Carmel, NY)
- …of one (1) year in a leadership role. * Minimum of Six (6) months of Clinical chart review and abstraction experience. * PREFER: Bachelor of Science in Nursing ... the hospital, community and medical staff. Meets with patients to provide clinical counseling regarding bloodless care. Population served based on scope of services… more
- Cognizant (Albany, NY)
- …and retro-authorization as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral, preauthorization, ... the medical necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and… more
- New York State Civil Service (Schenectady, NY)
- …behavioral, community problems and social issues.* Participates in complex assessments and or review clinical documentation as part secondary review to ... in receipts of services in state operated programs.* Collects, review , analyze and present data/metrics tied to clinical... review , analyze and present data/metrics tied to clinical and/or performance measures and utilize data to improve… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Contract Specialist (Cancer Center Focus) will be the point of contact for review , preparation, processing, and negotiation of Clinical Trial Agreements (CTAs), ... Law, Healthcare, Science) at least 3 years of experience in clinical research contract review and negotiation or an equivalent combination of education and… more
- Nuvance Health (Carmel, NY)
- …KPI's. * Holds monthly clinical meetings with providers and staff to review clinical KPI and implement/monitor process improvement plan. * Utilizes patient ... for Full-time externals only, pro-rated for Part-time *Medical Practice Clinical Lead RN position in the Gastroenterology department in...1 day per week after onboarding period. Summary: The Clinical Lead RN works with the clinical … more
- Touro University (Brooklyn, NY)
- …following: + Direct and indirect supervision of graduate speech-language pathology students in clinical practicum: + Regular review of client session plans and ... Overview Reporting to the Department Chair and the Clinical Director, the Clinical Supervisor has responsibility for supervision of graduate student clinicians… more
- Catholic Health Services (Smithtown, NY)
- …of care and ensuring compliance with regulatory standards. Key Responsibilities: Clinical Reimbursement: + Documentation: Review and analyze resident ... resident and patient, every time. Job Details Summary: The Clinical Reimbursement and Quality Management plays a vital role...of resident care services to maximize reimbursement. + Claim Review : Review and analyze submitted claims for… more
- Molina Healthcare (Albany, NY)
- JOB DESCRIPTION **Job Summary** The Care Review Clinician RN provides support for clinical member services review assessment processes. Responsible for ... verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired… more
- Mount Sinai Health System (New York, NY)
- …identify areas of opportunity and provide guidance through QI process. + Regularly review clinical documentations to ensure adherence to policy and accepted ... will join a collaborative team that works closely with clinical providers, administrative staff, and other stakeholders to develop,...Preferred: + A minimum of 3 years of recent clinical experience in an adult ICU setting within a… more
- Molina Healthcare (Albany, NY)
- JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery… more