- 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 Case Management practice. The Case Manager will work cooperatively with the Physician Advisor and Team. DUTIES AND RESPONSIBILITIES: ** 1. Determines medical … more
- Sedgwick (Albany, NY)
- …narcotic use contract with client. + Maintains accurate record system of pharmacy utilization review and complex pharmacy reviews to include cost savings, ... and dosage, and monitor complex drug regimens; to provide medical necessity reviews to evaluate, implement, and monitor options...and data collection. + Interacts and coordinates work of physician advisors as needed; performs complex review … more
- Spectrum Health and Human Services (Buffalo, NY)
- …Care Coordinator will be responsible for the following outcomes: to reduce utilization associated with avoidable and preventable inpatient stays, to reduce ... utilization associated with avoidable emergency room visits, to improve...RESPONSIBILITIES: + Complete a comprehensive health assessment/reassessment inclusive of medical /behavioral/rehabilitative and long term care and social service needs.… more
- Nuvance Health (Poughkeepsie, NY)
- …in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care ... physician practices locations, including The Heart Center, a leading...of a 40-hour National Board of Diving and Hyperbaric Medical Technology (NBDHMT) - approved, Introductory Hyperbaric Medicine Course.… more
- CDPHP (Albany, NY)
- …of prescription and medical benefits as it applies to the utilization review process. + Must demonstrate proficient experience with the Microsoft ... Must be conscientious, efficient and accurate in prior authorization, exception and medical /Rx necessity review processing. + Continually strive to develop… more
- Amgen (New York, NY)
- …+ 6 years' experience with specialty/biologic self-injectable (pharmacy benefit) or physician -administered (buy and bill/ medical benefit) products + Advanced ... HUB, providing live one-on-one coverage support + Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer… more
- WellLife Network (South Richmond Hill, NY)
- …location and schedules are subject to change. + Attend certification inspections, utilization review and independent professional reviews as needed. + Attend ... such care directly or through supervision. Essential Accountabilities: + Coordinate medical pre-admission evaluations and screening of prospective clients. + … 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 ... to influence other services by focusing on patient processes. 8.Develops and implements Utilization Review (UR) based on internal data collection, data received… more
- WMCHealth (Kingston, NY)
- …the patient based on subjective and objective information obtained through interview, medical chart review , formal and informal test administration, with ... functional evaluation of the client; conducts the planning and utilization of a program of purposeful activities; implements the...be rendered on the prescription or referral of a physician , nurse practitioner or other health care provider acting… more
- YesCare Corp (Coxsackie, NY)
- …measures including sentinel event review . + Actively participant of the Utilization Review process and follow proper procedures. + Provides appropriate ... appropriate. + Initiates consultation requests and non-formulary request with supervisory physician 's approval. + Educates patients relative to medical … more