- Guthrie (Binghamton, NY)
- …health care services regarding admissions, case management, discharge planning and utilization review . Responsibilites: Reviews admissions and service requests ... planning needs with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversees and coordinates compliance to… more
- CDPHP (Albany, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and ... for a rewarding career. Established in 1984, CDPHP is a physician -founded, member-focused, and community-based not-for-profit health plan that offers high-quality… more
- Catholic Health Services (Melville, NY)
- …queries from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, ... was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews...and level of care to MCC in response to physician order, or review of updated clinical… more
- WMCHealth (Valhalla, NY)
- …continuous education to physicians as needed on payor policies and workflows. + Utilizes medical review guidelines and parameters to assure consistency in the ... management areas of Integrated Case Management including mentoring/coaching care coordinators, utilization review staff and social workers. + Reviews cases… more
- Mohawk Valley Health System (Utica, NY)
- …specialist regarding correct level of care and reimbursement. Apply knowledge of utilization review , discharge planning, patient status changes, length of stay, ... billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of...and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides… more
- Catholic Health Services (Melville, NY)
- …Initiatives Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical ... York, as applicable. Certification by American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) preferred. 4. Knowledge, Skills and… more
- STG International (West Seneca, NY)
- …safety. + Participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... the Primary Care Physician is to provide covered professional outpatient primary medical services to enrolled patients of the Veterans Affairs Medical Center… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …and peer review . Participates and facilitates implementation of modern care, utilization of new technologies and new procedures. This includes but is not limited ... Summary This position is located at the Albany Stratton VA Medical Center, Albany, New York in the Department of Diagnostic Imaging. The Vascular Interventional… more
- MTA (Brooklyn, NY)
- …on the Paratransit Eligibility Appeals Board. The physician will provide medical expertise and support in the review of Access-A-Ride application documents ... Department of Occupational Health Services is seeking a full-time medical physician to provide coverage to New...(1) year of this experience. + Required to obtain Medical Review Officer (MRO) certifications within 6… more
- Veterans Affairs, Veterans Health Administration (Montrose, NY)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... responsibilities: participation in staff meetings, hospital committees, and peer review process. Demonstrate effective communication from staff to leadership, to… more