- Garnet Health (Harris, NY)
- …for the detox patient on the medical floor assuring discharge planning, utilization review , and insurance approval. At Garnet Health, we are committed to ... Social Worker on our Emergency Department team at/in Garnet Health Medical Center-Callicoon. Responsibilities The Social Worker will be responsible for implementing… more
- New York State Civil Service (Claverack, NY)
- …research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or ... health and substance use screens, youth and collateral interviews, and record review to develop a psychosocial assessment and subsequent mental health treatment… more
- Stony Brook University (Commack, NY)
- …improvement and monthly/quarterly outcome reporting. + Conduct regular drug utilization reviews (DUR), controlled substance audits, prescriber reviews and other ... audits to ensure prescribing patterns meet Program standards and rules for medical necessity for the treatment of certified conditions and other formulary rules. +… more
- CDPHP (Albany, NY)
- …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 ... (2) years experience in a health insurance related discipline required. + Utilization management experience is preferred. + Knowledge of managed care, health plan… more
- Sedgwick (Albany, NY)
- …physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... files are properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state and … more
- Cognizant (Albany, NY)
- …experience. * Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. * Must be able to work with ... 2 years claim processing is required. * Knowledge of physician practice and hospital coding, and medical ...of physician practice and hospital coding, and medical terminology, CPT, HCPCS, ICD-10 * Experience making payments… more
- UHS (Johnson City, NY)
- …Primary Department, Division, or Unit: Maternity and Newborn Nursery, UHS Wilson Medical Center Primary Work Shift: Day Rotational Regular Scheduled Weekly Hours: 40 ... and the delivery of health care services. + RESOURCE UTILIZATION : Evaluates and administers the resources of nursing services....Comprehensive Benefits for Life & Family - We offer medical , dental, and vision coverage starting the first of… more
- CUNY (New York, NY)
- …of Medicine (CUNY SoM) located in the heart of Harlem, New York, is the only medical school in the City University of New York system and the only public medical ... 2016. The CUNY SoM offers an accelerated BS/MD degree (7-year program) and a Physician Assistant Master's Degree (27 months program). True to its legacy of access,… more
- Elevance Health (Latham, NY)
- …of the care management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of care management ... providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires BA/BS in… more
- WMCHealth (Kingston, NY)
- …the patient information from the Philips Azurion 7 M20 to ISCV for Physician review . + Effective communicator with colleagues and providers regarding the ... and patient care treatment activities under the direct supervision of the medical and clinical staff. The position will appropriately document all procedures… more