- CVS Health (Albany, NY)
- …legal, compliance, or rework projects. + Ensure staff provide detailed written summaries of medical record review findings and ensure the team articulates ... in determining correct coding and appropriate documentation during the review of medical records . This...+ A minimum of 5 years of experience in medical record review for coding… more
- Molina Healthcare (Albany, NY)
- …Access and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/utilization review , and/or other utilization management ... + Must have valid driver's license with good driving record and be able to drive within applicable state...Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of InterQual /… more
- Centene Corporation (New York, NY)
- …management, cost containment, and medical quality improvement activities. + Perform medical review activities pertaining to utilization review , quality ... review of complex, controversial, or experimental medical services. + Support the effective implementation of performance...by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA… more
- Centene Corporation (New York, NY)
- …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... review of complex, controversial, or experimental medical services, ensuring timely and quality decision making. +...by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA… more
- Sumitomo Pharma (Albany, NY)
- …Initiated Study and Collaborative Research program. + Provide detailed and compliant medical review and approval of external resources, communications, and ... as appropriate. + Capable of translating brand goals and objectives into actionable medical and scientific strategies. + Proven track record of detailed,… more
- City of New York (New York, NY)
- …with the Division's Drug and Alcohol Testing Unit, Employee Assistance Unit, and Medical Records Unit. The responsibilities will include but are not limited ... problem areas, and take corrective action as needed. - Serve as a Medical Review Officer for DSNY's drug and alcohol testing program. - Educate staff within… more
- Humana (Albany, NY)
- …management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present ... health topics to the clinical operations team and healthcare organization. The Medical Director's work includes computer based review of moderately complex… more
- Regeneron Pharmaceuticals (Tarrytown, NY)
- …leading study start-up, directing and guiding study team execution, data cleaning, medical review , database locks, handling health authority responses are also ... The Executive Medical Director, Hematology, will provide overall clinical scientific...if you have the following:** + Demonstrated consistent track record in a range of leadership roles that include… more
- Trinity Health (Rensselaer, NY)
- …Brings patient to exam room, takes appropriate vital signs and documents in electronic medical record . Review and update medication list to ensure accurate ... and complete list in electronic medical record (EMR) available for provider review and submission. Complete referrals and tracks patients' compliance. … more
- Humana (Albany, NY)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... complex clinical scenarios, review of all submitted clinical records , prioritization of daily work, communication of decisions to internal associates, and… more