- Elevance Health (New York, NY)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… more
- Catholic Health Services (West Islip, NY)
- …with Hospital Conditions of Participation. Implements care management programs, including utilization review , intake and discharge planning. Evaluates patient ... collaboratively with, but not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals, Managed Care and Revenue Cycle and Patient… more
- Bassett Healthcare (Cooperstown, NY)
- …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. Identifies expected outcomes individualized to the… more
- Bassett Healthcare (Cobleskill, NY)
- …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. Identifies expected outcomes individualized to the… more
- BAE Systems (Greenlawn, NY)
- …assigned programs. Have the ability to: + Assists the Operation program Manager on Operations performance against the baseline program plan by monitoring quality, ... proposal generation and customer negotiation support and development of budgets. + Review of project performance against established metrics and development of "get… more
- WMCHealth (Kingston, NY)
- …that performs a functional evaluation of the client; conducts the planning and utilization of a program of purposeful activities; implements the development and ... utilization of a treatment program, and/or consultation with the...subjective and objective information obtained through interview, medical chart review , formal and informal test administration, with appropriate analysis… more
- Bassett Healthcare (Cooperstown, NY)
- …as measured by direct supervisory observation and random supervisory chart review Demonstrates consideration of safety, effective utilization of equipment ... no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback Analyzes assessment data to… more
- Highmark Health (Albany, NY)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
- Gas Field Specialists (Horseheads, NY)
- …by GFS employees and sub-contractors in the shop and/or field. * Acts as QA/QC Manager 's proxy in the absence of the QA/QC Manager . * Performs Quality Control ... Quality Assurance (QA) process audits. * Assists with the sustainment and full utilization of the project QMS (quality management system). * Conducts of necessary… more
- Catholic Health (Buffalo, NY)
- …+ Two (2) years acute care RN experience required + Preferred prior insurance /managed care/ utilization review experience in the role of a Case Manager or ... 7:30am to 5:30pm/8:00am to 6:00pm Summary: The RN Care Manager , Transition of Care, as an active member of...case management and discharge planning principles, the RN Care Manager , Transition of Care engages the patient/patient representative in… more