• Care Facilitator- Per Diem- Canton-Potsdam…

    Rochester Regional Health (Rochester, NY)
    …stay of patients across the continuum. + Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care based on medical ... necessity in the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization , performing continued stay… more
    Rochester Regional Health (04/26/25)
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  • Case Manager- Case Management

    Arnot Health (Elmira, NY)
    …the Case Management practice. The Case Manager will work cooperatively with the Physician Advisor and Team. DUTIES AND RESPONSIBILITIES: ** 1. Determines medical ... the management of patient care. The Case Manager will review all patients for utilization management and...Case Manager will review all patients for utilization management and appropriate discharge planning. The Case Manager's… more
    Arnot Health (05/08/25)
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  • Nurse Case Manager - Full Time, Days

    Nuvance Health (Poughkeepsie, NY)
    …and at a minimum the case manager reviews observation cases daily. 3. Utilizes physician advisor to interface with physicians as needed. 4. Collaborates with the ... or BSN preferred. Must have current RN license. Preferred experience in Utilization Review /Management.Company: Vassar Brothers Medical Center Org Unit: 1190… more
    Nuvance Health (04/26/25)
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  • Director Clinical and DRG Denials

    Kaleida Health (Buffalo, NY)
    …as facilitating strong working relationships between HIM, Clinical Documentation, UR, Physician Advisor operations, PFS, Contracting, and hospital departments ... and insurance / managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG denial management required. **Working… more
    Kaleida Health (03/20/25)
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  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    …of auth/denial review decisions. 8. Maintains a working relationship with Physician Advisor regarding physician issues related to auths/denials. 9. ... Bachelor's in nursing preferred. Must have proficient writing skills.Experience in Utilization Review and InterQual required. CARDIOPULMONARY RESUSCITATION (CPR)… more
    Arnot Health (05/08/25)
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  • Dialysis Clinical Manager Registered Nurse - RN

    Fresenius Medical Center (Amsterdam, NY)
    …departments and external customers; particularly in problem resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. + ... staff in problem solving. **PHYSICIANS:** + Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. + Responsible… more
    Fresenius Medical Center (05/15/25)
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