- Cognizant (Albany, NY)
- …experience. * Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. * Must be able to work with ... is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate adjudication of… more
- CDPHP (Albany, NY)
- …for a rewarding career. Established in 1984, CDPHP is a physician -founded, member-focused, and community-based not-for-profit health plan that offers high-quality ... invites you to be a part of that experience. The clinical support specialist (CSS) provides administrative support to clinical staff within Member Health. The CSS… more
- Northwell Health (Manhasset, NY)
- …and provide pharmacy recommendations + Education and development of nurse, physician and pharmacy staff development pertaining to transplant and immunosuppression. + ... and research. + Develops and monitors the hospital's policies/procedures regarding utilization of medications in collaboration with the medical staff, Pharmacy, and… more
- Bassett Healthcare (Cooperstown, NY)
- …a principle liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate bed ... IP CM/SW Communicate any urgent needs to IP CM/SW Utilization Review : Complete admission review ...collaborates with UM Nurse as needed Assists Clinical Documentation Specialist in engaging physician to respond to… more
- New York State Civil Service (Wassaic, NY)
- …1, Speech Language Pathologist 2, Teacher 4 (and all parenthetics), Training Specialist 1 (Nursing), and Utilization Review Coordinator. Additional ... direct supervision to Placement Coordinator, Residential Training Coordinator, Habilitation Specialist Coordinator, and Recreation Therapist.* Conduct site visits routinely,… more
- New York State Civil Service (Poughkeepsie, NY)
- …1, Speech Language Pathologist 2, Teacher 4 (and all parenthetics), Training Specialist 1 (Nursing), and Utilization Review Coordinator. Additional ... Chief Physical Therapist, Chief Recreation Therapist, Developmental Disabilities Program Specialist 1, Developmental Disabilities Program Specialist 1 (Spanish… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The (per diem) Utilization Review Specialist coordinates scheduling of all surgical/endoscopic hospital admissions, pre-admission testing ... testing and operating room time. 7. Checks credentials system for physician 's delineation of privileges for equipment and/or procedures according to medical… more
- Albany Medical Center (Albany, NY)
- …within the Pediatric Endocrine division. Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse ... to patients in clinic, under the direction of a physician or APP + Participates in in-office procedure, as...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
- Guthrie (Corning, NY)
- …and autonomy in nursing practice. Preferred experience with PCMH process, care management/ utilization review , and payer knowledge. Fast paced ambulatory care ... an inpatient stay for all identified patients. + e. Collaborates with patient, physician , and other care team members in assessing the patients progress toward… more
- Rochester Regional Health (Rochester, NY)
- …of the Medical Management Department to maintain daily operations. Oversees the daily review process of the third party payors ensuring information is tracked and ... maintained. Creates departmental reports for senior management. RESPONSIBILITIES + Oversees the review process of third party payors with oversight from the Director… more