- MVP Health Care (Tarrytown, NY)
- …improvement. To achieve this, we're looking for a **Professional, Sub-Acute RN UM Reviewer - Medicare** to join #TeamMVP. If you have a passion for patient-centered ... teams to ensure optimal patient care and resource utilization. + Document review outcomes and maintain compliance with regulatory and organizational standards. +… more
- City of New York (New York, NY)
- …Construction, Public Buildings Division, Architecture & Engineering Unit seeks a Design Reviewer (Electrical). The duties for this position will include, but are not ... limited to, project scoping, design and/or review of consultant drawings and specifications (utilizing Blue-Beam), site inspection and reports, ad hoc technical… more
- City of New York (New York, NY)
- …Buildings, Architecture and Engineering Sustainability Unit seeks a Senior Design Reviewer (Sustainability) for the Office of Sustainable Design. The selected ... capital projects. The key responsibilities include project scope development, technical review of consultant design documents related to sustainable design and… more
- EGA Associates (Albany, NY)
- …Urgency** Normal **Offering** Nursing **Profession** RN **Specialty** Complaint Intake Reviewer **Job ID** 17430566 **Shift Details** **Shifts Per Week** 5 ... **scheduledHrs_1** 40.0 **Job Order Details** **Start Date** 2025-12-08 **End Date** 2027-12-07 **Duration** 104 Week(s) **Float Required** No **Call Required** No **Client Details** **Client Type** Commercial **Address** 875 Central Ave **City** Albany… more
- MetLife (Oriskany, NY)
- Job Title Group Life Claim Reviewer Job Location Virtual within a commutable distance of Oriskany / Central NY. New Hires Should live within a commutable distance of ... our office in Oriskany NY. Training In- Person Training for 4 to 6 weeks, Monday through Friday, 8 AM to 4:30 PM. Functional Responsibilities * Checks Group Life claim documentation or other company forms for completeness and accuracy. * Evaluate Group Life… more
- Guthrie (Cortland, NY)
- Summary The LPN Utilization Management (UM) Reviewer , in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and the Robert Packer ... Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior authorization/certification for reimbursement of patient care services. The responsibilities include: + Facilitating communication… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member ... and treatment of members' behavioral health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member ... and treatment of members' medical health conditions, applying established clinical review criteria, guidelines and medical policies and contractual benefits as well… more
- M&T Bank (Buffalo, NY)
- **Overview:** Completes entry-level review of documents from Institutional clients and reports on identified exceptions. **Primary Responsibilities:** + Complete ... Custody tracking system to original documents. The data for review is uploaded to the tracking system for reporting...and update the tracking system accordingly. + Follow basic review criteria according to established procedures. + Update the… more
- City of New York (New York, NY)
- …justice services programs serving New York City's children and families. The PAMS review evaluates provider agency practice on critical city and state priorities in ... - Evaluate contracted provider agency case practice utilizing the standardized PAMS review tool - Compile, analyze and enter performance data into computerize case… more