- Fresenius Medical Center (Mineola, NY)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Whitney Young Health Center (Albany, NY)
- Registered Nurse (RN) Care Manager (Req 100984) Albany, NY (http://maps.google.com/maps?q=920+Lark+Drive+Albany+NY+USA+12207) Apply Description Be a part of the ... the patient as well as various WYH health care staff to achieve an effective continuity of care. SPECIFIC...focusing care coordination attention on the at-risk population driving utilization and costs to improve efficiency, quality and patient… more
- Molina Healthcare (Rochester, NY)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care… more
- Trinity Health (Syracuse, NY)
- … Utilization Management and works collaboratively with Utilization Management/Concurrent Review Nurse , physicians, staff and other health care ... identification of possible concurrent denials, forwards information to the appropriate Utilization Management/Concurrent Review Nurse within identified… more
- Mount Sinai Health System (New York, NY)
- …The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse , Physician Assistant, or Nurse Practitioner, who manages the 24 ... includes but is not limited to, policy and program development, staff training, patient assessments, patient throughput, managing patient emergencies and supporting… more
- Molina Healthcare (Albany, NY)
- …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... for serving as the primary liaison between administration and medical staff . Assures the ongoing development and implementation of policies and procedures… more
- Molina Healthcare (Yonkers, NY)
- …in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership ... the chief medical officer. * Evaluates authorization requests in timely support of nurse reviewers, reviews cases requiring concurrent review and manages the… 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 ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to...of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's… more
- Northwell Health (Staten Island, NY)
- …case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. * Keeps ... concurrent utilization management using Interqual criteria. * Conducts chart review for appropriateness of admission and continued length of stay. * Contacts… more
- Mount Sinai Health System (New York, NY)
- …Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager ... are not limited to: a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using… more