- WMCHealth (Valhalla, NY)
- …+ Provides clinical rational for standard and expedited appeals. + Participate in peer -to- peer review with payors and/or complete appeals as required ... leveling and/or appeals agency preferred. Previous utilization management, case management or peer review documentation experience in hospitals or health plans.… more
- Bassett Healthcare (Cooperstown, NY)
- …staff member goes into waiting area to greet patient as observed by supervisor and/or peer review , and rooms patient as soon as possible. Patient is identified ... with National Patient Safety Goals as observed by supervisor and/or peer review Documents with accuracy patient work-up information, such as vital signs,… more
- Rockefeller University (New York, NY)
- …the Executive Editor is responsible for the administration of _JEM;_ maintaining a fair peer review process; selection of all content published in _JEM;_ writing ... **Operational Management:** + Manage day-to-day operations of the journal, including peer review processes and other editorial operations + Manage an editorial… more
- Molina Healthcare (Yonkers, NY)
- …manages Medical Directors + Develops medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** **REQUIRED EDUCATION:** * Doctorate Degree in ... in Utilization/Quality Program management + Previous leadership experience + Peer review , medical policy/procedure development, and provider contracting… more
- WMCHealth (Suffern, NY)
- …. Reviews, and as appropriate, investigates actual or potential safety events. . Performs chart review for quality or peer review . . In collaboration with ... Medical Staff Leadership assures timely completion of peer review activities. . Provides leadership for internal quality, peer review and mortality and… more
- Mohawk Valley Health System (Utica, NY)
- …(all payer types) and reimbursement models in decision making and reviews. + Provide peer -to- peer payor review in collaboration with attending physicians. + ... appeals as requested for commercial payors. + Perform reviews and appeals. ( Peer -to- peer , retrospective/closed record review , concurrent appeals). + Act… more
- City National Bank (New York, NY)
- …wealth planning strategies in areas of interest to UHNW clients. * Submit for peer review all client-facing custom designed output. * Support the Wealth Strategy ... using Salesforce (within the permission allowed by the Saleforce COE). * Peer review client-facing custom designed output from other Sr. Wealth Strategist. *… more
- Mount Sinai Health System (New York, NY)
- …a resource person to nurses and other health team members. + Participates in peer review . + Incorporates research findings in clinical practice. + Participates ... person to nurses and other health team members. + Participates in peer review . + Incorporates research findings in clinical practice. + Participates in approved… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …BH and PH care across the UM/ CM staff. + Participates in clinical peer review recruitment and supervision. + Collaborates with Provider Relations staff to ... program following NYS directives and guidelines. + Completes medical necessity reviews and peer -to- peer calls in timely manner and provides support for the Case… more
- Highmark Health (Albany, NY)
- …defining test strategy and assumptions + 1 year of test case and test plan peer review **Preferred** + 5 years of developing test automation software according ... Test engineers are expected to participate in refining the CICD process, code review their code, and engage in manual testing. **ESSENTIAL RESPONSIBILITIES** + Work… more