- Bassett Healthcare (Oneonta, NY)
- …up emergent situations or expressed patient problems directly to Supervisor or Supervising Nurse for assistance as observed by Supervisor and Supervising Nurse ... of Advanced Beneficiary Notice signatures and form processing to meet Medicare regulations. Ensures all corrections (demographics, insurance eligibility etc. based… more
- New York State Civil Service (Schenectady, NY)
- …primary medical care, working in collaboration with other physician(s) and nurse practitioners or midlevel providers for adults with developmental disabilities and ... Schuylerville. Duties would include but not be limited to review and establish medical histories, perform physical examinations, and...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
- Molina Healthcare (Rochester, NY)
- **Job Summary** **_For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of KENTUCKY or have a compact license._** Provides ... and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements...focus on promoting the quality, accuracy, and efficiency of review services. + Serve as a resource and subject… more
- Fresenius Medical Center (Camillus, NY)
- …effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies procedures and training and in compliance ... well-being since their last treatment. Report any complaints or observations to the nurse supervisor. + Evaluate vascular access for patency and report any unusual… more
- Bassett Healthcare (Cooperstown, NY)
- …of care (LOC) and hospital protocols to make recommendations for unit placement Review traditional Medicare fee for service (FFS) using the two-midnight rule ... liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate bed is assigned,… more
- Humana (Albany, NY)
- …a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on our 5+ million ... to assist and facilitate new hires and remediation of medical directors performing Medicare utilization management processes and be the liaison for the Medicare … more
- Ellis Medicine (Schenectady, NY)
- …by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and social workers for ... in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly preferred. Home care, payer, or… more
- New York State Civil Service (Poughkeepsie, NY)
- …team consisting of direct care staff and clinicians including the psychologist, dietitian, nurse , and other titles. * Monitors all budgetary concerns in the IRAs as ... Head Recreation Therapist, Licensed Psychologist, Mental Hygiene Nursing Program Coordinator, Nurse Administrator 1, Nurse Administrator 2, Nutrition Services… more
- Option Care Health (New Rochelle, NY)
- …is maintained by providing direct patient care 20-40% of the time. In a Medicare Certified Home Health agency, this position may also serve as the alternate ... Director of Nursing of the Home Health Agency for Medicare certified home health agencies in the absence of...reporting nursing operational and financial data to the Regional Nurse Manager, Area Director of Nursing, and/or Director of… more
- Stony Brook University (Stony Brook, NY)
- …may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR from the ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...Documents over utilization of resources and services. + All Medicare cases are reviewed for level of care on… more