- WMCHealth (Valhalla, NY)
- …cases when clinical determinations cannot be made by initial clinical review . + Discusses determinations with requesting physicians or ordering providers when ... clinical rational for standard and expedited appeals. + Participate in peer-to-peer review with payors and/or complete appeals as required to overturn denials. +… more
- Access: Supports For Living (Middletown, NY)
- …all internal and external audits + Lead QA/program annual meetings and protocol review . + Leads and provides oversight on the development of Quality Assurance ... department activities of Internal QA regulatory review audits, QA Monthly Reports, Billing Grids, Documentation Curriculum, Program Personnel, Regulation Tracking,… more
- Lotte Biologics USA LLC (Syracuse, NY)
- …on-floor observation and through active collection, routine process and data monitoring/ review , and statistical analysis of process performance data/trends + Drive ... different data trending and statistical analysis tools to complete process review , modeling, principal component analysis, and multivariate analysis + Author… more
- Mount Sinai Health System (New York, NY)
- …interprets the clients responses to the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion but not less than every ... person to nurses and other health team members. + Participates in peer review . + Incorporates research findings in clinical practice. + Participates in approved… more
- New York State Civil Service (Albany, NY)
- …also reviews and provides comments on design-phase project documents.Essential Functions* Review and analyze claims in coordination with internal and external ... participate as directed in the negotiation of fair and reasonable claim resolution.* Review and recommend approval of change orders, ensuring work is within the… more
- MUFG (New York, NY)
- …Validation (IM Validation) team and engaging with business partners to resolve review comments and discrepancies. This role requires someone with a strong ... once they are recognized and agreed as issues + Review management action plans (MAPs) development to ensure MAPs...Defense (LoDs) and risk treatment is properly identified. + Review issue intake submissions for tollgates ( review … more
- University of Rochester (Rochester, NY)
- …and provide feedback on evaluations for direct and indirect reports. + Review and evaluate proposed promotions or terminations as appropriate. + Participate and ... and reviews timecards for accuracy to assist with payroll processing. + Review department budget for accuracy and provide feedback to increase efficiencies in… more
- City of New York (New York, NY)
- …reviews for DEP in accordance with all applicable City Environmental Quality Review (CEQR) and State Environmental Quality Review (SEQR) regulations. In ... strategic planning to help ensure appropriate forecasting, trend analysis, regulatory review , scientific modeling, and research. The Environmental Impact Analysis &… more
- City of New York (New York, NY)
- …as a Quality Control Case Reviewer, who will: - Conduct the preliminary monthly review of MICSA and HCSP cases selected from a sample of activated, recertified, ... Query (SOLQ) databases. - Ensure the accuracy of the review sample by conducting preliminary WMS inquiries and case... sample by conducting preliminary WMS inquiries and case review ; utilize reports to verify that sample is auditable;… more
- City of New York (New York, NY)
- …City. Working within the Bureau of Water & Sewer Operations (BWSO), the Plan Review Section review the engineering proposals for various types of projects ... sewer facilities within the five boroughs of the City. Review of these submittals is necessary to determine the...water main Infrastructure. This position is also for to review the plans for new sewer and water main… more