- Centene Corporation (New York, NY)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... license.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance… more
- Elderwood (Buffalo, NY)
- …Pharmacy Billing Department in Williamsville, NY is seeking an experienced, detail-oriented Accounts Review Specialist to join our team and make a difference in the ... on-site! Benefits of working at Woodmark of NY: + Full Benefits Package - Medical , Dental, Vision, Life + 401(k) with company match + Recognition Program with points… more
- Centene Corporation (New York, NY)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies… more
- Rochester Regional Health (Rochester, NY)
- …area, nurses perform comprehensive assessments and preparation, including: + Medical history review , medication reconciliation, allergy screening + ... Pre-operative testing (eg, blood work, EKGs) + Coordination of care with anesthesia and surgical teams + Informed consent education and emotional support for patients and families Post-Anesthesia Care In the PACU, highly trained nurses provide vigilant… more
- Help at Home (Brooklyn, NY)
- …records, ensuring compliance with DOH mandates + Conduct monthly follow-ups regarding employee medical compliance + Review and verify employee files pre- and ... post-orientation + Assist in coordinating in-service trainings and employee benefits administration + Participate in audits and reporting (eg, I-9, CHRC, vendor audits) + Recommend disciplinary actions and process terminations when necessary + Issue employment… more
- WMCHealth (Kingston, NY)
- …the patient based on subjective and objective information obtained through interview, medical chart review , formal and informal test administration, with ... appropriate analysis and interpretation of results, to develop a plan of care. Establishes a written treatment plan based upon the results of the evaluation to establish objective, measurable, functional patient focused goals with time frames. Re-assesses the… more
- Molina Healthcare (Albany, NY)
- JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary ... * Processes requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents cases in a consistent and efficient manner.… more
- CDPHP (Latham, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation for ... authorization. This includes approval determinations and appropriate exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is… more
- Albany Medical Center (Albany, NY)
- …provided by Physicians of Albany Med by completing appeals, phone calls, and account review . This position is a Medical billing position for a Physician ... Salary Range: $38,937.60 - $50,618.88 This position is a Medical billing position for a Physician Practice. Providing efficient...Albany Med by completing appeals, phone calls, and account review . Qualifications: + High school diploma or GED is… more
- Charles B. Wang Community Health Center (Queens, NY)
- …Internal Medicine service to improve the health care of patients, including peer review , medical and regulatory education, and risk management training + ... no in-patient responsibility. Responsibilities : + Responsible for the medical care of a panel of adult patients +...Supervise and teach nurse practitioners, nursing staff and medical students as needed + Meet minimum productivity targets… more