- Arnot Health (Elmira, NY)
- …related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case ... of admission and stay in accordance with Interqual. ** 2. Prepares Medicare /Non Medicare hospital notices of noncoverage (HINN) when patient's level… more
- New York State Civil Service (Monroe, NY)
- …reviews, and residential habilitation. Develop and present individuals' cases to review committees which include Human Rights Committee, Informed Consent Committee, ... case reviews, and residential habilitation.* Develop and present individuals' cases to review committees which include: HRC, ICC, and LRMC for approval. Participate… more
- Northwell Health (Staten Island, NY)
- …* Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of stay. + ... companies and physicians regarding utilization issues. + Utilizes important message from Medicare (IMM) when appropriate. + Ensures managed care reviews are up to… more
- New York State Civil Service (Queens Village, NY)
- …as a member of an interdisciplinary treatment team and attend meetings for case review ; * Participate in and lead individual, family and group counseling sessions; * ... and maintain a wide variety of records. * Peer review . LinkedIn: https://www.linkedin.com/company/nys-office-for-people-with-developmental-disabilities/posts/?feedView=all #LI-MG1 Minimum Qualifications Minimum Qualifications for… more
- Arnot Health (Bath, NY)
- …of the Long Term Care staff, attends weekly care conference meetings, and weekly Medicare A review with care team and therapies. + Demonstrates effective time ... of resident care. e. Assists the DON with implementing appropriate review systems for competency-based appraisals of staff. f. Participates in Nursing/Medical… more
- New York State Civil Service (NY)
- …as a member of an interdisciplinary treatment team and attend meetings for case review ; * Participate in and lead individual, family and group counseling sessions; * ... and maintain a wide variety of records. * Peer review . LinkedIn: https://www.linkedin.com/company/nys-office-for-people-with-developmental-disabilities/posts/?feedView=all #LI-JL2 Minimum Qualifications Minimum Qualifications for… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …timely manner and provides support for the Case Management (CM) and Registered Nurse (RN) reviewers and manages the denial process. + Leads interdisciplinary complex ... the UM/ CM staff. + Participates in clinical peer review recruitment and supervision. + Collaborates with Provider Relations...without restrictions and free of sanctions from Medicaid or Medicare required. + Minimum of five (5) years of… more
- Trinity Health (Albany, NY)
- …for the overall patient safety and clinical risk management functions related to review and response to reported events. Responds to crisis situations that have ... is strongly preferred). Master's degree preferred. Certification (CPHRM) is preferred. Registered Nurse preferred. Ideally, the candidate will have 3-5 years in risk… more
- New York State Civil Service (Brooklyn, NY)
- …hours.*Serve as health advisor to multi-disciplinary team; provide consultation/peer review to other physicians/clinicians; supervise nurse practitioner; ... eligibility for full and unconditional participation in the Medicaid and Medicare programs which must be maintained for continued employment. Failure to… more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …Demonstrates an understanding of MDS requirements related to varied payers including Medicare , Managed Care and Medicaid + Ensures timely electronic submission of ... on a monthly basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates in, and attends various other… more