- 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
- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... from payors for additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as… more
- Catholic Health Services (Melville, NY)
- …for services and coordinates utilization /appeals management review. + Assist Utilization and Appeals Manager in setting up communications with payors ... as a liaison between patient account services, physicians, care coordinators, Utilization and Appeals Managers, physician advisors and facility departments.… more
- Catholic Health Services (Melville, NY)
- …practice in a hospital strongly preferred. + Two years administrative background as physician manager preferred. + Previous experience as a physician ... presents to Physician Advisors during the monthly Physician Advisor meeting. + Attends hospital Utilization ...monthly Physician Advisor meeting. + Attends hospital Utilization Management (UM) committees. + Supervises the Facility … more
- University of Rochester (Rochester, NY)
- …improvement to increase utilization and/or ease of scheduling to access center manager and practice manager . Acts as subject matter expert and information ... internal equity considerations._ **Responsibilities:** GENERAL PURPOSE Oversees and directs Physician Support employees in their assigned divisions. Assigns and… more
- STG International (Auburn, NY)
- STGi is currently seeking a Primary Care Physician to provide services at our Community Based Outpatient Clinic. JOB SUMMARY: The general duty of the Primary Care ... Physician is to provide covered professional outpatient primary medical...procedures and suggest improvements. * Assist the STGi Program Manager in implementation of Quality Performance Improvement Team (QPIT)… more
- STG International (Kingston, NY)
- THIS IS FOR A FUTURE OPENING STGi is currently seeking a Primary Care Physician to provide services at our Community Based Outpatient Clinic. JOB SUMMARY: The ... general duty of the Primary Care Physician is to provide covered professional outpatient primary medical...procedures and suggest improvements. + Assist the STGi Program Manager in implementation of Quality Performance Improvement Team (QPIT)… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Mount Sinai Health System is seeking a Medical Director of Physician Engagement and CDQI!** **Background:** Mount Sinai is one of the largest ... quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1) be responsible...for driving key population health goals including access, quality, utilization and accurate risk adjustment with a group of… more
- University of Rochester (Rochester, NY)
- …**Responsibilities:** GENERAL PURPOSE Under the direct supervision of the Practice Manager , Clinic Director and Nurse Manager works with considerable ... the time and effort of providers by reviewing reports such as Clinic Utilization , Master Templates and the volume of Referrals. + Develops, enforces and continuously… more
- Guthrie (Binghamton, NY)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in ... of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates the physician and… more