- Veterans Affairs, Veterans Health Administration (Bronx, NY)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities The James J. Peters VA Medical Center is recruiting for Full-Time Physician (Anesthesiology). The incumbent will be Board-Eligible or… more
- Sedgwick (Albany, NY)
- …**PRIMARY PURPOSE OF THE ROLE:** To perform provider outreach, specialized document review , and analysis and interpretation of interventions for the preparation of ... and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or...to the next round, recruiter will be in touch. \# nurse #medicare #medicaresetaside _As required by law, Sedgwick provides… more
- Elevance Health (Middletown, NY)
- …prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification ... I** is responsible for coordinating cases for precertification and prior authorization review . **How will you make an impact:** + Managing incoming calls or… more
- Mount Sinai Health System (New York, NY)
- …+ Current New York State license as a Registered Professional Nurse or other licensed/certified clinical professional strongly preferred; foreign healthcare ... Conducts Root Cause Analysis investigations, which includes assessing need for focused review by departments, and or clinical chairpersons for peer reviews. 5.… more
- Arnot Health (Elmira, NY)
- …Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and retrospective authorization and ... discourage preventable denials DUTIES AND RESPONSIBILITIES: 1. Retrospectively determines medical necessity and appropriateness of admission and stay in accordance… more
- Independent Health (Buffalo, NY)
- …UM, Medical Case Management, and SIU for specific BH related case review , product/benefit development, claims , servicing and network as directed. + Review ... counselor (LPC), licensed family or marriage therapist (LMFT) or active registered nurse (RN) in NYS required. Certified Case Manager (CCM) required. Candidates… more
- GE Vernova (Schenectady, NY)
- …to Customs. + Active engagement of pre and post shipment audit review , inclusive of valuation, classification, country of origin and applicable special program ... Conduct internal training specific to Customs operations. + Support active review and revisions of business policies, procedures and manuals associated with… more
- Trinity Health (Albany, NY)
- …for the overall patient safety and clinical risk management functions related to review and response to reported events. Responds to crisis situations that have ... is strongly preferred). Master's degree preferred. Certification (CPHRM) is preferred. Registered Nurse preferred. Ideally, the candidate will have 3-5 years in risk… more
- BronxCare Health System (Bronx, NY)
- …projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate preferred ... collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement… more
- GE Vernova (Saratoga Springs, NY)
- …Presents all financial data in a transparent way, attends project and management review to present cost status + Provides change order calculations to ensure ... data and books + Support project close out and claims + Lead the team of Project Cost Control...range ONLY, not used for Canada) **Healthcare benefits include medical , dental, vision, and prescription drug coverage; access to… more