- CVS Health (New York, NY)
- …multi-vendor z/OS software products, ensuring optimal performance and reliability. + **Advanced Utilization ** : Leverage a wide array of z/OS products and utilities ... and third-party software integration, ensuring optimal partnerships and resource utilization . **EDUCATION** Bachelor's degree or, equivalent experience (HS diploma +… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- About The Role MagnaCare provides Utilization Review/ Case Management/ Medical Management/Claims Review services to its clients. Care Coordinators facilitate care ... management and utilization review by performing data collection & data entry,...services. Primary Responsibilities + Collect data from claimant representative, physician , or hospital; verify claimant case status and provider… more
- Catholic Health Services (Smithtown, NY)
- …across the acute care continuum. + Performs required activities for utilization management, PRI assessment and completion, transition planning, and identification of ... (all status/types). + Partners with ED nurse, ED charge nurse, and ED physician to communicate with patients about their admission and plan of care. QUALIFICATIONS:… more
- Rochester Regional Health (Rochester, NY)
- …to improve clinical practice. * Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research ... Support (BLS) certification PREFERRED QUALIFICATIONS + Acute care, chart review, utilization , or nursing triage experience strongly preferred. EDUCATION: AS: Nursing… more
- Elevance Health (Buffalo, NY)
- …illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a thorough and accurate member ... the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through… more
- Mount Sinai Health System (Long Island City, NY)
- …The Director will direct and manage departmental activities involved in utilization review, appeals management and discharge planning to facilitate the case ... influence other services by focusing on patient processes. 8.Develops and implements Utilization Review (UR) based on internal data collection, data received from… more
- SUNY Upstate Medical University (Syracuse, NY)
- …other healthcare professionals and medical facilities + Communicate with collaborating physician or specialist regarding patient care Provides exemplary patient care ... Timely and accurate patient follow up + Efficient utilization of support team members + Effective utilization... utilization of support team members + Effective utilization of EMR system Minimum Qualifications: NYS licensed/registered NP… more
- Grifols Shared Services North America, Inc (Albany, NY)
- …are relevant and specific to each influencer in the decision process ( Physician , Academic Centers ie neurology department with residents and fellows, Infusion Suite ... aligned with customer segmentation and enhance formulary and dosing protocols. * Utilization of Managed Markets, Marketing, Ig Nurse Educators, MSL, etc. *Educate… more
- Catholic Health Services (Melville, NY)
- …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 ... accurate according to payer requirements. The role will work closely with Utilization Management, Patient Accounts, and other key stakeholders in the revenue cycle… more
- Northwell Health (Sleepy Hollow, NY)
- …163159 Job Description Serves as liaison between the patient and facility/ physician . Ensures a continuum of quality patient care throughout hospitalization and ... + Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + Submits… more
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