- CenterWell (Hauppauge, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- Stony Brook University (Stony Brook, NY)
- …Coordinator: investigates issues and presents findings and recommendations to Associate Technical Director SL-5, as assigned. + Conducts monthly review of ... Laboratory sections). Under the direction of TH Assoc Technical Director , she /he will be responsible for oversight of...and LIS (Clinisys & CoPath) order entry and result review screens, new tests additions to the test menu,… more
- Arnot Health (Elmira, NY)
- …Bachelor's in nursing preferred. Must have proficient writing skills.Experience in Utilization Review and InterQual required. CARDIOPULMONARY RESUSCITATION (CPR) ... Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal...denied by payer. Under the direction of the System Director of Care Coordination coordinates data with other Arnot… more
- Mount Sinai Health System (New York, NY)
- …to: 1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using standardized ... Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or...Sinai St. Luke's and Mount Sinai West, BEZ - Utilization Management - WST, Mount Sinai West… more
- CUNY (New York, NY)
- …Level 1 (Provisional) **GENERAL DUTIES** Studies, evaluates, and analyzes space utilization and requirements, consistent with the environmental and program needs of ... and judgment, as follows: - Conducts field surveys to review and inspect CUNY facilities, obtains relevant data to...Assures that all plans produced are accurate based on management guidelines and other information provided. - Coordinates the… more
- Rochester Regional Health (Rochester, NY)
- …case coordination/patient navigation for patients, including triage management , algorithm management , utilization management and resource management . ... after admission-within the first 12 to 24 hours. Applies utilization review criteria to assess and document...documentation on each patient. + Makes referrals to administrative director , medical director , quality management ,… more
- City of New York (New York, NY)
- …& Innovation, Contract Administration, Contract Compliance and Opportunities, Purchasing Management , Accounts Payable Unit, Contracts Review and Negotiations, ... maintain records of proposed and current Agency's Requirement Contracts. Ensure the utilization of these contracts by Procurement Liaisons. Review specifications… more
- City of New York (New York, NY)
- …& Innovation, Contract Administration, Contract Compliance and Opportunities, Purchasing Management , Accounts Payable Unit, Contracts Review and Negotiations, ... maintain records of proposed and current Agency's Requirement Contracts. Ensure the utilization of these contracts by Procurement Liaisons. Review specifications… more
- Ellis Medicine (Schenectady, NY)
- …plan, implement and evaluate individual healthcare needs. Integrate Discharge Planning, Utilization Review and Performance Improvement activities at the patient, ... levels. Efficiently and effectively anticipates, identifies and resolves issues through utilization review and discharge planning processes. Collaborates with… more
- Molina Healthcare (NY)
- …comply with CMS guidelines. These staff may also be involved in providing utilization management /prior authorization services as needed. * Supervises the unit's ... (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy… more