- Excellus BlueCross BlueShield (Buffalo, NY)
- …timely manner and provides support for the Case Management (CM) and Registered Nurse (RN) reviewers and manages the denial process. + Leads interdisciplinary complex ... and PH care across the UM/ CM staff. + Participates in clinical peer review recruitment and supervision. + Collaborates with Provider Relations staff to ensure an… more
- Insight Global (Lake Success, NY)
- …ensures the accuracy and integrity of clinical documentation by conducting concurrent reviews of inpatient records and collaborating with physicians to clarify ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more
- Mount Sinai Health System (New York, NY)
- …preferred)New York State License with current registration as a registered professional nurse . Certification in specialty area preferred. , 851 - Geriatrics and ... data analytics team **Principal Duties and Responsibilities** **General** + Manage multiple concurrent projects with detailed plans and task lists to ensure timely… more
- Catholic Health Services (West Islip, NY)
- …Conditions of Participation. Implements care management programs, including utilization review , intake and discharge planning. Evaluates patient care data to ... and federal, state and QIO regulations. Familiarity with admission and concurrent in-patient criteria is preferred. Experience with data analytics preferred.… more