- Evolent (Albany, NY)
- …Pain Management, reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, ... when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the MD review… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records ... and receives guidance where needed. Follows established guidelines/procedures. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters,… more
- Fresenius Medical Center (Troy, NY)
- …Perform additional duties as assigned. **ADDENDUM FOR PATIENT CARE TECHNICIANS WORKING IN THE HOME PROGRAMS (NOT HOME ASSIST):** Assisting the HT RN: + May ... assist HT RN on Home Visit as directed + Reinforces PD / HHD...skills, and competencies. Hourly Rate: $15.00 - $24.00 **Fresenius Medical Care maintains a drug-free workplace in accordance with… more
- Fresenius Medical Center (New Rochelle, NY)
- …Perform additional duties as assigned. **ADDENDUM FOR PATIENT CARE TECHNICIANS WORKING IN THE HOME PROGRAMS (NOT HOME ASSIST):** Assisting the HT RN: + May ... assist HT RN on Home Visit as directed + Reinforces PD / HHD...skills, and competencies. Hourly Rate: $18.00 - $29.00 **Fresenius Medical Care maintains a drug-free workplace in accordance with… more
- Evolent (Albany, NY)
- …redefining how care is delivered for individuals facing cancer. As a Performance Suite Medical Director in Medical Oncology, you will play a pivotal role in ... a focus on **value-based strategy and transformation** . Unlike traditional medical review roles that emphasize volume throughput, this position integrates… more
- Evolent (Albany, NY)
- …match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, ... and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the MD… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services… more
- City of New York (New York, NY)
- …INCLUDE BUT NOT BE LIMITED TO: - Act as principal advisor to the Medical Director on the development, execution, and monitoring of high-profile priority projects and ... programs. Support the Medical Director in the functioning of the ...you healthy while serving New Yorkers. - Work From Home Policy: Depending on your position, you may be… more
- CenterWell (Albany, NY)
- **Become a part of our caring community and help us put health first** The Medical Director, Primary Care relies on medical background and reviews health claims. ... of situations or data requires an in-depth evaluation of variable factors. The Medical Director relies on medical background and reviews health claims. The… more