- Catholic Health (Buffalo, NY)
- …parties (the payers) and internal stakeholders including, but not limited to, Utilization Review , Case Management , Clinical Documentation Integrity, Health ... operational analysis, information systems or related field + Registered Nurse with a four (4) year degree and Unrestricted... management + Certification in a Nationally Recognized Utilization Review Criteria set is preferred EXPERIENCE… more
- Villa of Hope (Rochester, NY)
- …coordinator, providers, director of LHTC and administrative team, including billing and utilization review . + Triages potential admissions and when needed ... JOB TITLE: Intake Coordinator- RN/ Evening DEPARTMENT/PROGRAM: Medical Services SUPERVISOR: Nurse Manager/Health Coordinator PAY GRADE: 82 FLSA STATUS: NON EXEMPT… more
- Northwell Health (Mount Kisco, NY)
- …Case Management and Social Work Services team. Develops processes to monitor utilization review inclusive of length of stay (LOS) and resource reduction ... facility best practices and makes recommendations for process improvement. Oversees resource utilization for the hospital and provides specific data analysis on … more
- Stony Brook University (Stony Brook, NY)
- … Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...assigned. Identifies, follows and documents Avoidable delays in Care Management Program. Reviews and documents on patients who were… more
- Catholic Health Services (West Islip, NY)
- …+ Ensures compliance with Hospital Conditions of Participation. + Implements care management programs, including utilization review , intake and discharge ... hospital care management leadership role is required. + Experience in utilization management , working with managed care organizations, and discharge planning… more
- University of Rochester (Rochester, NY)
- …Serves as the primary internal contact for national and state registry data management questions, issues or concerns, but not limited to clinical data collection, ... validation, delivery, reconciliation, and data management activity timeliness. Concurrently and retrospectively reviews medical records and data to identify patient… more
- Molina Healthcare (Bronx, NY)
- …and cost-effective member care. Essential Job Duties * Performs audits in utilization management , care management , member assessment, behavioral health, ... care experience, with at least 1 year experience in utilization management , care management , and/or...equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
- Albany Medical Center (Albany, NY)
- …short- and long-term goals and objectives. As a member of the nursing executive management team, the AVP participates in the efficient and effective management ... Licensure, Certification & Registration: + Must hold a current NYS Registered Nurse license. Experience: + 7-10 years of experience in nursing, involving… more
- MVP Health Care (Schenectady, NY)
- …every interaction **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes ... **Qualifications you'll bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months… more
- Nuvance Health (Poughkeepsie, NY)
- …Course. The hyperbaric chamber operator assists in the provision of safe and therapeutic management of patient care to an assigned group of patients through the ... utilization Standards of Practice and policies and procedures and...patient care within the scope of practice as a Nurse (RN or LPN), Respiratory Therapist, EMT, Paramedic. *… more