- Excellus BlueCross BlueShield (Rochester, NY)
- …by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address ... Provider Relations, explaining processes for accessing Health Plan to perform medical review , obtains case or disease management support, or otherwise interacts… more
- Elevance Health (New York, NY)
- …medical decisions to members and providers. **How you will make an impact:** + Perform physician -level case review , following initial nurse review , of ... Medical Oncology regimens and supportive care. + Perform physician -level case review , following initial nurse review , of chemotherapy regimens. +… more
- Elevance Health (New York, NY)
- …state mandated policies, and CMS Coverage Determinations, as applicable. + Perform physician -level case review of utilization requests for procedures ... policies when making medical necessity decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director review or… more
- Mount Sinai Health System (New York, NY)
- …MSAHC guaranteeing adherence to all aspects of clinical service delivery, reporting, incident review , and high-risk case management + Knowledge of and ability to ... Title of interest and send CV with Cover Letter to:** ** Physician Recruitment Department** **Mount Sinai Health System** ###@mountsinai.org **Responsibilities** A.… more