- DePaul (Rochester, NY)
- …outcomes activities as determined appropriate. + Provide support to the Quality Management Vice-President, Quality Management Director and Quality ... Management Plan within the corporation. + Incident Management - review incident reports and provide...reporting and follow-up consultation and training. + Responsible for Utilization Record Review functions to include Individual… more
- Bassett Healthcare (Cooperstown, NY)
- …to staff regarding "new" therapeutic modalities and medications (measured by leadership review ) + Assists supervisor, manager and director in training of ... and continuing education of current employees (measured by peer review and management observation) + Acts as...Respiratory Care Department in absence of supervisor, manager and director + Assists in full utilization of… 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
- Fresenius Medical Center (New York, NY)
- …compliance and regulatory requirements and programs. Collaborates with the Medical Director and the Clinical Coordinator /Charge Nurse or Nurse Supervisor regarding ... Coordinator/Charge RN or Nurse Supervisor acting as nurse manager, the Medical Director , and the physicians regarding the direct patient care responsibilities within… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …in conjunction with Medical Policy leadership and applicable Medical Director (s). Essential Accountabilities: + Develops and maintains corporate medical policies ... + In collaboration with the Lead Medical Policy Coordinators, tracks the annual review requirements of assigned policies ensuring all annual reviews are completed in… more
- Elevance Health (Middletown, NY)
- …equivalent. + Requires a minimum of 4 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN license ... **Medical Management Clinician** **Location:** **New York** . This role...a medical necessity denial determination made by a Medical Director . + May work directly with healthcare providers to… 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
- Touro University (Hawthorne, NY)
- …management techniques. + Assist in solving patient-related problems + Assist the Director in the review within their clinical practice, each student's ... with disabilities, and veterans. Responsibilities Directly reporting to the Director of Orthodontics, Touro College of Dental Medicines, ...+ Guide doctor/patient interaction + Aid in the continual review of student rosters. + In the case of… more