- Excellus BlueCross BlueShield (Buffalo, NY)
- …Accountabilities: Level I + Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs ... medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.… more
- Catholic Health (Buffalo, NY)
- …Cycle and interdisciplinary care team and works in conjunction with the Utilization Review Manager and Manager Clinical Documentation Integrity. The Middle Revenue ... Cycle - Clinical Supervisor is responsible for training and mentoring Utilization Review, Clinical Documentation Integrity and Clinical Denials and Appeals teams.… more
- WMCHealth (Hawthorne, NY)
- …AR, payor mix, billing throughput and other performance statistics. + Physician and Mid-level provider productivity, utilization , patient referrals, ... and forecast financial performance. + Coordinate with practice operations and physician leaders to develop and oversee transition plan for capital assets,… more
- Centene Corporation (New York, NY)
- …York + Board certified in Internal Medicine or Family Medicine + Utilization Management experience and knowledge of quality accreditation standards. + Actively ... for the business unit. + Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. + Performs… more
- Ellis Medicine (Schenectady, NY)
- …appropriate Level of Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending physician for additional ... provided by the Case Manager include, but are not limited to, utilization review, case management, care transition, collaboration with physicians and social workers… more
- Mount Sinai Health System (New York, NY)
- …on reducing the length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice and may require ... Requirements + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager… more
- Guthrie (Binghamton, NY)
- …of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates the physician and ... for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with other internal… more
- Wolters Kluwer (New York, NY)
- …Engagement Manager plays a high-impact role in managing strategy and product utilization across the Wolters Kluwer Health's Clinical Decision Support & Provider ... are established and strengthened, drive product adoption and ensure utilization goals are achieved to maximize value realization, implementation projects… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Services area including, but not limited to, Medical and Pharmacy Utilization Management, quality management, member care management, and medical policy processes, ... I + Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review...of Medicine or Doctor of Osteopathic Medicine. + The Physician is not the subject of any pending professional… more
- Mount Sinai Health System (New York, NY)
- …and treatments plans are not required to be countersigned by a physician . **PRINCIPLES DUTIES AND RESPONSIBILITIES** **CLINICAL PRACTICE** + Assesses the health ... plan of care in the patient's medical record. + Consults with physician according to established standards, policies, procedures, and protocols. + Demonstrates the… more
Recent Jobs
-
Project Developer (Miso/PJM/NY/NE))
- Vistra (Irving, TX)
-
Janitor (Part Time) - Four Flags Plaza
- KMG Prestige (Niles, MI)