- Molina Healthcare (Buffalo, NY)
- …works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, ... required. This can vary based on the individual State Plan . + Must be able to travel within applicable...Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (Syracuse, NY)
- …works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, ... + Provides telephone, clerical, and data entry support for the Care Review team. + Provides computer entries of authorization request/provider inquiries, such as… more
- MUFG (New York, NY)
- …portfolios to identify deterioration or negative management control trends and review compliance with policies, guidelines, and regulations. + Prepare periodic Risk ... Serve as Examiner-In-Charge (EIC) for complex portfolios or processes. As EIC, effectively plan , coordinate and oversee all aspects of on-site activities. + Focus on… more
- Molina Healthcare (Syracuse, NY)
- **JOB DESCRIPTION** ARIZONA RESIDENCY REQUIRED** This position will support the Arizona state Plan . We are seeking a candidate with an Arizona RN/and or a compact ... members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across...required. This can vary based on the individual State Plan . + Must be able to travel within applicable… more
- Molina Healthcare (Syracuse, NY)
- …works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, ... a related field. **Preferred Experience** Utilization Management experience Health Plan /MCO work experience **Preferred License, Certification, Association** Board Certified… more
- Molina Healthcare (Rochester, NY)
- …works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, ... may be required. This can vary based on the individual State Plan . **JOB QUALIFICATIONS** **Required Education** Graduate from an Accredited School of Nursing.… more
- WMCHealth (Valhalla, NY)
- …cases when clinical determinations cannot be made by initial clinical review . + Discusses determinations with requesting physicians or ordering providers when ... for standard and expedited appeals. + Participate in peer-to-peer review with payors and/or complete appeals as required to...Physician Advisor or having 3-5 years as a Physician Reviewer /Advisor with a third party leveling and/or appeals agency… more
- Sumitomo Pharma (Albany, NY)
- …team based in the US. He/she will primarily function as the Regulatory reviewer for assigned products. This position is responsible for providing strategic, expert ... limited coaching and mentoring. **Job Duties and Responsibilities** Advertising & Promotion Review Activities + Review and approve materials that comply with… more
- Colliers Engineering & Design (Albany, NY)
- …Proficiency in technical skills in construction services including, but not limited to, plan review and site inspections, QA/QC adherence and staying in ... Quality Plan ) in conjunction with project team, including quality reviewer . + Prepare proposals (assumptions, scope of work, budget, etc.) as appropriate.… more
- Terracon (Rochester, NY)
- …of plans and specifications, observation and inspection, and the writing, preparation, and review of related reports for the services provided. Review drawings ... and recommend changes. Research and resolve design and construction problems. Assign, review , and evaluate laboratory or field data for inclusion in reports. Apply… more