- WMCHealth (Valhalla, NY)
- …and problems. + Participates in daily review of aggregate denials/appeals with the Medical Director , peer, or the Clinical Review Supervisor. + Provides ... is responsible for developing positive relationships with both employed and affiliated medical staff members in order to fulfill strategic business growth and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director , Pharmacist, Geriatrics, etc.) to ensure continuity ... consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …all mandatory trainings as required.* May be required to attend Fair Hearings with Medical Director relating to specific cases.* Works independently, as well as ... Community Health Assessment (CHA) Tools to determine functional status, medical , behavioral, psychological, and community resource needs for coordinating,… more