- Nuvance Health (Poughkeepsie, NY)
- …Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology ... from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within the assigned… more
- Cardinal Health (Albany, NY)
- …audits to determine organizational integrity of billing for professional ( physician ) services and/or hospital (technical) services, including: detection and ... and coding and billing standards; communication of audit results to physicians, physician leadership, senior leadership, management, and staff; physician and… more
- Guthrie (Corning, NY)
- …of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates the physician and ... medical management through ongoing interaction with the patient and family/caregivers, physician and other health care providers to achieve designated clinical,… more
- Amgen (Syracuse, NY)
- …HUB, providing live one-on-one coverage support + Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer ... Offer office education during the access process, including formulary coverage/ utilization management criteria, insurance forms & procedures, benefits investigation,… 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 ... providers in coordination with others in the organization + Provides feedback to physician and leadership on the educational opportunities found as a result of… more
- Weill Cornell Medical College (New York, NY)
- …level healthcare provider working under the delegated authority of a supervising physician . The role and responsibilities extend beyond those of the Registered Nurse ... advanced clinical services or other tasks delegated by the supervising physician , consistent with education, training and practice protocols, policies and… more
- Mount Sinai Health System (New York, NY)
- …The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse, Physician Assistant, or Nurse Practitioner, who manages the 24 hour a day ... patient-centered care. **Qualifications** Must be a Licensed Registered Nurse, Physician Assistant or Nurse Practitioner Registered Nurse Bachelor?s Degree in… more
- Humana (Albany, NY)
- …scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, ... with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or… more
- Catholic Health (Buffalo, NY)
- …payers) and internal stakeholders including, but not limited to, Utilization Review, Case Management, Clinical Documentation Integrity, Health Information ... Management, Physicians and Physician leadership, Finance, Information Technology and other Clinical stakeholders....approved by management + Certification in a Nationally Recognized Utilization Review Criteria set is preferred EXPERIENCE + Minimum… more
- CenterWell (Westbury, NY)
- …care plans and interpreting patient needs, while adhering to Company, physician , and/or health facility procedures/policies. + Manages the assignment of caregivers. ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts… more