- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review ... and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a… more
- MVP Health Care (Tarrytown, NY)
- …+ Minimum of 5 years of clinical practice experience + Managed care, utilization management , or health plan operations experience preferred. + Experience working ... improvement. To achieve this, we're looking for a **Medical Director , Clinical Review and Care Integrity** to...criteria and regulatory requirements. + Provide clinical support across Utilization Management , Case Management , Appeals,… more
- Stony Brook University (Stony Brook, NY)
- …Coordinate the design, development, implementation, and monitoring of the organization's case management and utilization review functions. + Lead initiatives ... Management leadership and staff functions related to case management and utilization management activities....and collaboration with Social Work Services * Knowledge of Utilization Review and Denial/Appeals * Knowledge of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review activities include: reviews of ... we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of... review determinations. + Provides input into the utilization management program policies and procedures. +… more
- MTA (New York, NY)
- Deputy Director Enterprise Asset Management Value Realization Job ID: 6664 Business Unit: MTA Headquarters Location: New York, NY, United States ... - $175,000 HAY POINTS : 1096 DEPT/DIV: Strategic Initiatives \ Enterprise Asset Management SUPERVISOR : Director , Enterprise Asset Management LOCATION :… more
- Centene Corporation (New York, NY)
- …functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management...Performs medical review activities pertaining to utilization review… more
- Evolent (Albany, NY)
- …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit… more
- Evolent (Albany, NY)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Mount Sinai Health System (Long Island City, NY)
- …The Director will direct and manage departmental activities involved in utilization review , appeals management and discharge planning to facilitate ... to influence other services by focusing on patient processes. 8.Develops and implements Utilization Review (UR) based on internal data collection, data received… more
- City of New York (New York, NY)
- …initiatives, and the implementation of integrated systems that govern real estate asset management and space utilization . The Director leads a profession ... and other building services, health/safety program coordination, lease and property management , land use and environmental review activities, contract… more