- Catholic Health Services (Melville, NY)
- …UR department, and presents to Physician Advisors during the monthly Physician Advisor meeting. + Attends hospital Utilization Management (UM) committees. + ... hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health, our primary focus is the… more
- Catholic Health Services (Melville, NY)
- …as a liaison between patient account services, physicians, care coordinators, Utilization and Appeals Managers, physician advisors and facility departments. ... a home health service, hospice and a network of physician practices across the island. At Catholic Health, our...Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help… more
- Mohawk Valley Health System (Utica, NY)
- …hospitals objectives, and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides the team to ... PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The...correct level of care and reimbursement. Apply knowledge of utilization review, discharge planning, patient status changes, length of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of clinical… more
- Catholic Health Services (Melville, NY)
- …from payors for additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as ... a home health service, hospice and a network of physician practices across the island. At Catholic Health, our...was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews… more
- Highmark Health (Albany, NY)
- …Inc. **Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician... utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and… more
- Northwell Health (Mount Kisco, NY)
- …such as arrivals, no-shows, cancellations, bumps, patient cycle time, exam room utilization , physician productivity, and appointment lag. + Upholds and ... **Req Number** 168236 Job Description Manages daily operations of multi- physician practice(s)/hospital services for a Department/Division or Service Line. Manages… more
- Guthrie (Binghamton, NY)
- Summary The Registered Nurse (RN) Utilization Management (UM) in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and ... CPT/ICD coding, medical record or chart auditing, and experience in utilization management processes preferred. Knowledge of computer applications (such as Microsoft… more
- CDPHP (Latham, NY)
- …for a rewarding career. Established in 1984, CDPHP is a physician -founded, member-focused, and community-based not-for-profit health plan that offers high-quality ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical...a Registered Nurse. + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge of coding/claims… more
- Mount Sinai Health System (Jamaica, NY)
- …Description** Under the general supervision of a licensed and Board-Certified Physician , evaluates and treats adult patients having medical, psychiatric, and/or ... patient care. **Qualifications** -Bachelor of Science or Master's degree in Physician Assistant Studies. Additional education/experience may be required for some… more
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