- Molina Healthcare (Syracuse, NY)
- …officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * Identifies and ... be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and member/provider inquiries/appeals. * Provides… more
- Molina Healthcare (NY)
- …Summary** Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. ... ensuring departmental and Centers for Medicare and Medicaid Services ( CMS ) standards are met. * Educates Molina members on...assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. *… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay. This… more
- Northwell Health (Huntington, NY)
- …and standards of practice. 16.Facilitates continual compliance for unit with the JC, CMS , New York State, DOH, Public Health Law, HIPPA regulations and System ... as needed. 6-8 years of nursing experience and 2-5 years of leadership/ management experience, required. BLS, ACLS & PALS required. Current PACU competency required.… more
- City of New York (New York, NY)
- …NYC Health Code-mandated clinical services, public health initiatives, chronic disease management , reproductive health care, and case management to ensure ... the supervision of the OSH Assistant Medical Director for High Schools, the CMS II (Supervising Physician - High Schools) will: - Participate in the development,… more
- Tioga Downs Casino Resort (Nichols, NY)
- …average bet, length of play and ensure the proper information is entered into the casino CMS system to record player history + Open and close games in assigned ... would like to take the next step toward a management career, we'd like to talk to you! Tioga...+ Exercise appropriate discretion in identifying situations that require management attention + Assure relationship-building by interacting and modeling… more
- Rochester Regional Health (Rochester, NY)
- …Participates and supports oversight of office processes of the Medical Management Department to maintain daily operations. Oversees the daily review process ... of third party payors are maintained. Creates departmental reports for senior management . RESPONSIBILITIES + Oversees the review process of third party payors with… more
- Northwell Health (Huntington, NY)
- …of scope and standards of practice. 13.Facilitates continual compliance with the JC, CMS , New York State, DOH, Public Health Law, HIPPA regulations and System ... as needed. 6-10 years of nursing experience and 5-7 years of leadership/ management experience, required. *Additional Salary Detail The salary range and/or hourly… more
- Inns of Aurora (Aurora, NY)
- …* Stay current on digital marketing trends, technologies, and best practices Content Development * Assist in the maintenance of the resort website, including ... report on website performance on an ongoing basis. Recommend written and visual content and structure optimizations based upon this data, and execute changes at the… more
- Mohawk Valley Health System (Utica, NY)
- …quality and revenue cycle operations. The coder assigns International Classification of Disease system - 10 (ICD), CM, and PCS codes according to AHA - AMA ... Guidelines, CMS and NGS. Core Job Responsibilities + Assign diagnosis...required. Education/Experience Requirements REQUIRED: + AS in Health Information Management , a related degree or equivalent experience +… more