- Bassett Healthcare (Cooperstown, NY)
- …as measured by direct supervisory observation and random supervisory chart review Demonstrates consideration of safety, effective utilization of equipment ... quality of life possible. What you'll do The STAT Nurse RN will provide clinical support and direct patient...than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback Analyzes… more
- Arnot Health (Elmira, NY)
- …processes related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The ... the Physician Advisor and Team. DUTIES AND RESPONSIBILITIES: ** 1. Determines medical necessity and appropriateness of admission and stay in accordance with… more
- Mount Sinai Health System (New York, NY)
- …in the Daily Management Board process/practice improvement activities to facilitate the utilization of evidence and data related to Nurse Sensitive Indicators ... **Job Description** The Director of Nursing Professional Practice is a professional nurse with broad knowledge and skill in the professional practice standards, NYS… more
- Northwell Health (Melville, NY)
- … Review standard and regulations. Performs concurrent and retrospective utilization management using evidenced-based medical necessity criteria; conducts ... plus specialized certifications as needed. Preferred Skills 3-5 years experience in Utilization Review , Case Management, and Clinical Appeals. 3-5 years of… more
- Nuvance Health (Poughkeepsie, NY)
- …of care. * Participates in quality assurance programs as requested by the Clinical Nurse Manager or Program Medical Director. * Participates in the safety ... Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary...care to an assigned group of patients through the utilization Standards of Practice and policies and procedures and… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include the supervision… more
- Molina Healthcare (Syracuse, NY)
- …role must complete courses required to obtain licensure in all states. + Utilization Review Lead responsibilities also include but not limited to, collaborate ... timely completion. + Actively participates in the Department auditing program to review and communicate findings with staff and identify opportunities for improved… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...patients who were readmitted within thirty days. Documents over utilization of resources and services. + All Medicare cases… more
- University of Rochester (Rochester, NY)
- …reconciliation, and data management activity timeliness. Concurrently and retrospectively reviews medical records and data to identify patient care, process, and ... application of strict inclusion/exclusion criteria and protocols. Performs meticulous chart review and enters clinical data into the quality databases to identify… more
- Mount Sinai Health System (Long Island City, NY)
- …Description** The Director will direct and manage departmental activities involved in utilization review , appeals management and discharge planning to facilitate ... years of Case Management and 6 years of clinical nurse experience. Previous supervisory experience in Case Management or...services by focusing on patient processes. 8.Develops and implements Utilization Review (UR) based on internal data… more