- Rochester Regional Health (Rochester, NY)
- Job Title: Utilization Review Specialist (RN) Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 Hours ... (Full-Time) Schedule: Monday - Friday, Days SUMMARY:The Utilization Review Specialist actively participates in the utilization management of patients and… more
- CDPHP (Latham, NY)
- …these values and invites you to be a part of that experience. The BH Utilization Specialist is responsible for coordination of care for CDPHP members across the ... an acute or subacute level of care. The BH Utilization Specialist will conduct telephonic care coordination...required) + In lieu of behavioral health license, Registered Nurse with valid New York State license, with experience… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
- Cognizant (Albany, NY)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- WMCHealth (Valhalla, NY)
- …and coding principles and guidelines; good knowledge of healthcare delivery system, utilization review , case review and quality improvement practice ... Clin. Documentation Specialist Company: NorthEast Provider Solutions Inc. City/State: Valhalla,...link Job Details: Job Summary: Provides clinically based concurrent review of patient medical records to ensure documentation accurately… more
- DePaul (Rochester, NY)
- …trends for reporting and follow-up consultation and training. + Responsible for Utilization Record Review functions to include Individual record audits, ... Overview The Quality Management Specialist works with the Quality Management Department to provide the highest achievable quality of services to the individuals we… more
- City of New York (New York, NY)
- …required; make professional recommendations accordingly. - Keep abreast of medical and utilization review techniques and developments relative to the nursing ... initiative, serves as a Head Nurse in the Bureau of Medical and Professional Review (BMPR) of Home Care Services Program. As the Head Nurse , they will… more
- Centene Corporation (Queens, NY)
- …Management Teams and / or activities / clinical documentation submitted by the Intake Specialist . The Clinical Quality Assurance RN will review for to confirm ... will spend time in the field while reviewing Intake Specialist work and will actively coach and develop staff...10 codes, medical abbreviations, medications. Experience in medical records review , claims processing or utilization and case… more
- Northwell Health (Manhasset, NY)
- …team and provide pharmacy recommendations + Education and development of nurse , physician and pharmacy staff development pertaining to transplant and ... and research. + Develops and monitors the hospital's policies/procedures regarding utilization of medications in collaboration with the medical staff, Pharmacy, and… more
- New York State Civil Service (Staten Island, NY)
- …1, Speech Language Pathologist 2, Teacher 4 (and all parenthetics), Training Specialist 1 (Nursing), and Utilization Review Coordinator. Additional ... List: Associate Psychologist, Audiologist 1, Audiologist 2, Community Mental Health Nurse , Developmental Assistant 3, Developmental Specialist 2, Developmental … more