- Sharecare (Albany, NY)
- …services + Uses technical and business development skills to increase client's utilization of current technology + Tracks, analyzes, creates, and delivers relevant ... collaboration with Director Client Success the QBR and Annual Review **Reporting** + Collaborate with the reporting team to...and dashboards and deliver monthly, quarterly and annually + Review and analyze reports for accuracy and outcomes needed… more
- Sharecare (Albany, NY)
- …producing quality work at all times. **Essential Job** **Functions:** + Review electronic records for HIPAA compliance, compliance with request and authorization ... limits. + Review documentation and determine if there is a legal...rules and regulations. + Meet established production, quality, and utilization goals. + Support other queues as needed to… more
- Sharecare (Albany, NY)
- …techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also ... in the orientation and to take the pre and post tests to review competency during orientation. Yearly competency tests are required for all Sharecare clinicians.… more
- Molina Healthcare (NY)
- …multiple data sources, crosswalks, and built-in validation checks. + Use peer-to-peer review process and end-user consultation to reduce errors and rework. + Assist ... Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare + Advanced knowledge of Databricks +… more
- Molina Healthcare (NY)
- …requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce errors and rework + Practice ... + Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare + Advanced knowledge of SQL + Proficient… more
- CenterWell (Westbury, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... **Branch Location** : Westbury, NY **This is not a remote or work-from-home position. This position requires you to...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- Fujifilm (Albany, NY)
- …identifying activities, sponsorships, and equipment needed to ensure success. + Review and consideration of event participation levels and requirements, involving ... key stakeholders as needed, and share with review committee for consideration. + Timely, proactive sharing and...data monitoring, analysis, summary, and report generation for sales utilization of Showpad materials and platform, including areas of… more
- Humana (Albany, NY)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Humana (Albany, NY)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Evolent (Albany, NY)
- …Job Description As a Clinical Reviewer, Nurse, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not...are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes… more