- Trinity Health (Syracuse, NY)
- …shifts. Emergency department experience preferred. **Position Purpose:** The Registered Nurse Utilization Review (UR), Clinical Care Manger (CCM) actively ... manages the utilization review process and patient progression from...between emergency services, surgical services, nursing, finance, physicians, and medical records. In addition, they are responsible to coordinate… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical information ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay.… more
- CenterWell (Albany, NY)
- …will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- CenterWell (Albany, NY)
- …will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review ... RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
- Samaritan Daytop Village (Rhinebeck, NY)
- …staff as needed with assuring compliance with external and internal utilization review /quality and appropriateness requirements. What qualifications do you ... mission and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory… more
- WMCHealth (Valhalla, NY)
- …of hospital services to patients; familiarity with the functions of hospital admitting, medical records and utilization review , particularly as they impact ... Credit&Coll Ana-Hospital Company: Westchester Medical Center City/State: Valhalla, NY Category: Clerical/Administrative Support Department: Admitting Union: Yes… more
- Bassett Healthcare (Cooperstown, NY)
- …a principle liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate ... CM/SW Communicate any urgent needs to IP CM/SW Utilization Review : Complete admission review for medical necessity on observation (OBS) and inpatients… more
- Seafield Center, Inc. (Westhampton Beach, NY)
- …documentation, including EMR entries, PAS forms, and consent forms + Liaise with Utilization Review , Medical , and Transportation departments + Maintain ... FOR FULL-TIME EMPLOYEES + Generous Paid Time Off + Medical , Dental, Vision Insurance + Flexible Spending Account (FSA)...accurate bed board and coordinate bed placements + Review hospital records for placement suitability; refer to alternate… more
- Centene Corporation (New York, NY)
- …on member medical records in health management systems according to utilization management policies and guidelines + Works with healthcare providers to approve ... 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national...delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken… more
- Molina Healthcare (Buffalo, NY)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in… more