- WMCHealth (Suffern, NY)
- …or resolves interventions on the nursing plan of care and/ or collaborates with physician regarding the need to revise the treatment plan. + Coordinates care with ... with other health care providers and community resources to ensure full utilization of support services which address patient needs. + Participates in Quality… more
- House of the Good Shepherd (Utica, NY)
- …Responsibilities: To provide a safe, healthy environment that supports acquisition and utilization of pro-social skills for youth residing in the HGS RTA residential ... complete Medication Certification training and pass medication in accordance with physician 's orders and record medications given according to agency guidelines and… more
- WMCHealth (Hawthorne, NY)
- …credentialing for the medical staff at Westchester Medical Center Advanced Physician Services. Primary responsibility of this position is ensuring that all ... assigned files and perform required daily tasks in a timely manner. + Utilization and maintenance of required credentialing related databases. + Maintains an Excel… more
- Rochester Regional Health (Rochester, NY)
- …updates documentation appropriately. + Completes at least one clinical research utilization (CRU) form for submission to the Nursing Research Department utilizing ... Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations. PAY RANGE: $37.18… more
- Rochester Regional Health (Rochester, NY)
- …updates documentation appropriately. + Completes at least one clinical research utilization (CRU) form for submission to the Nursing Research Department utilizing ... Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations. PAY RANGE: $37.18… more
- Molina Healthcare (Buffalo, NY)
- …such meetings would occur to discuss and resolve issues related to utilization management, pharmacy, quality of care, and correct coding. * Independently delivers ... managed healthcare setting ideally in negotiating different provider contract types, ie physician , groups and hospitals). To all current Molina employees: If you are… more
- WMCHealth (Warwick, NY)
- …ensure facility compliance with Nursing Care Standards as applied to Resource Utilization Groups. The MDS Nurse assume responsibility for accurate completion of MDS ... eligibility for Medicare coverage. Initiates Medicare Certification and recertification for physician signature as needed. + Monitor assessment schedules and nursing… more
- Molina Healthcare (Yonkers, NY)
- …from government and accreditation regulators. + Directs the team in providing physician leadership and expertise in the performance of prior authorization, inpatient ... experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review, medical… more
- Sedgwick (Albany, NY)
- …lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization ... review. + Maintains professional client relationships. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing**… more
- Nuvance Health (Carmel, NY)
- …Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology ... RN experience in an acute care setting; Leadership experience preferred; Utilization review, discharge planning or case management experience preferred. Location:… more