- CDPHP (Latham, 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
- UHS (Johnson City, NY)
- …and name band data entry, auditing, and maintenance as assigned. + Reconciles physician orders for consultations in electronic medical record (EMR) + Completes ... OR staff. Primary Department, Division, or Unit: Delivery Room, UHS Wilson Medical Center Primary Work Shift: Night Regular Scheduled Weekly Hours: 36 Compensation… more
- Rochester Regional Health (Rochester, NY)
- …with Directors of Nursing and Director of Quality to provide quality review activities. Guides assigned areas in utilization of recognized improvement ... Medicine and Surgery Service Line. Works collaboratively with operational leadership and physician leadership to develop budgets based on volumes and scope of… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The (per diem) Utilization Review Specialist coordinates scheduling of all surgical/endoscopic hospital admissions, pre-admission testing and ... preadmission testing and operating room time. 7. Checks credentials system for physician 's delineation of privileges for equipment and/or procedures according to … more
- Cardinal Health (Albany, NY)
- …to physician or hospital (inpatient and outpatient) billing and/or medical necessity reviews. + Prepares written reports of audit findings and recommendations; ... Management, Business or related field preferred. + 6+ years of experience in physician and/or hospital coding and auditing, medical necessity reviews, or related… more
- WellLife Network (South Richmond Hill, NY)
- …location and schedules are subject to change. 5. Attend certification inspections, utilization review and independent professional reviews as needed. 6. Attend ... such care directly or through supervision. **Essential Accountabilities:** 1. Coordinate medical pre-admission evaluations and screening of prospective clients. 2. … more
- Northwell Health (Manhasset, NY)
- …projects and research. + Develops and monitors the hospital's policies/procedures regarding utilization of medications in collaboration with the medical staff, ... transplant pharmacy services (inpatient and outpatient). Collaborates with the multidisciplinary medical staff and establishes criteria for the safe, effective and… more
- Guthrie (Binghamton, NY)
- …leadership and autonomy in nursing practice. + Preferred experience with care management/ utilization review , and payer knowledge. + RN considered. Education: + ... performs the Medicare Annual Wellness Visit under the direct supervision of a physician ( physician on site) for beneficiaries to identify a personalized and… more
- CDPHP (Latham, 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 ... for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources.… more
- Nuvance Health (Poughkeepsie, NY)
- …invite you to discover what's possible for you and your career. Vassar Brothers Medical Center (VBMC) is a renowned, 349-bed regional medical center overlooking ... leader in the Mid-Hudson Valley, we offer comprehensive, subspecialized medical , surgical, and obstetrical/gynecological services to the entire community. Our… more