- 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
- Mount Sinai Health System (New York, NY)
- …data models. + Extensive knowledge of healthcare/medical data such as hospital/ physician claims, utilization data, and healthcare industry coding systems ... and revenue codes. + Excellent interpersonal skills and experience working with senior management and other leaders, along with the ability to communicate concepts to others without an IT background. + Experience implementing data governance, metadata… more
- Guthrie (Cortland, NY)
- Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and the Robert ... Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior authorization/certification for… 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
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time) Schedule: Monday - Friday, ... as needed. Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act as a resource on denial management as… 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
- Highmark Health (Albany, NY)
- …coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by ... the physician against medical policy criteria. The incumbent then uses...prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to… more
- Ellis Medicine (Schenectady, NY)
- …schedulers to communicate open time availability + Coordinates operating room schedules with physician availability to maximize utilization of OR time + Displays ... participates in the creation of the daily surgical schedule optimizing block utilization and customer satisfaction, participates in the creation of the pre-admission… more
- Northwell Health (New Hyde Park, NY)
- …such as arrivals, no-shows, cancellations, bumps, patient cycle time, exam room utilization , physician productivity, and appointment lag. + Upholds and ... communicates the mission, vision and values of the organization across multiple Practices and/or Cost Centers and/or Locations and/or Hospital; manages and maintains relationships between Practices and/or Cost Centers and/or Locations and/or Hospital, staff… more
- Whitney Young Health Center (Albany, NY)
- School Based Health Nurse Practitioner/ Physician Assistant (NP/PA) (Req 100961) Albany, NY (http://maps.google.com/maps?q=900+Lark+Drive+Albany+NY+USA+12207) Apply ... benefits and more! GENERAL RESPONSIBILITIES: The School Based Health Nurse Practitioner/ Physician Assistant (NP/PA) will provide primary health care services as a… more