- CVS Health (New York, NY)
- …responses to members and providers. Leads all aspects of utilization review / quality assurance, directing case management Provides clinical expertise and ... is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. **This is a remote… more
- Ellis Medicine (Schenectady, NY)
- …staff and students using appropriate competency documents. + Actively participates in quality assurance documentation, review and + Participates in ongoing ... in a cost effective manner in an environment that promotes continuous quality improvement. EDUCATION AND EXPERIENCE REQUIREMENTS: Education: + A high school diploma… more
- Comunilife (New York, NY)
- …to assure quality program service delivery and participates in Utilization Review / Quality Improvement process. + Participate in case finding, networking and ... outreach activities to increase clients' enrollment. + Works closely with agency's program directors to ensure assure continuity of care within the organization. Qualifications Education and Experience Requirement(s) + Associate's Degree in human services or… more
- Molina Healthcare (Albany, NY)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/utilization review , and/or other utilization management activities aimed at providing… more
- UMB Bank (Albany, NY)
- …Administration** team is responsible for company-wide credit oversight, including credit quality , policy, administration and credit related processes, with a focus ... under normal and stressed scenarios. Within Credit Administration, the **Appraisal Review ** team supports Commercial, Small Business and Consumer Lending. As a… more
- Centene Corporation (New York, NY)
- …setting to determine overall health and appropriate level of care + Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
- MUFG (New York, NY)
- …enterprise-wide risk management practices. You will evaluate, monitor, and report on the quality of risk assets and effectiveness of the Bank's processes to control ... portfolios to identify deterioration or negative management control trends and review compliance with policies, guidelines, and regulations. + Prepare periodic Risk… more
- Intermountain Health (Albany, NY)
- …for optimization of reviews while patients are hospitalized. It aids in the review of quality measures including Patient Safety Indicators and Hospital Acquired ... Integrity (CDI) Registered Nurses (RN) and Intermountain Physician Advisors to review complex facility encounters and assign International Classification of Diseases… more
- Catholic Health Services (Melville, NY)
- …the state of New York, as applicable. Certification by American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) preferred. 4. Knowledge, ... Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical documentation. Works… more
- The Institute for Family Health (Bronx, NY)
- …care reports generated by IFH stats & other available population management registries to review site quality metrics, track aggregate data and identify at risk ... the multidisciplinary team and in accordance with approved protocols, provides high quality patient care, Diabetes Self-Management Education and Support as well as… more