- Calvary Hospital (Bronx, NY)
- …Transit Check. + Free On-Site Parking Requirements Participates in the Utilization Review, Discharge Planning, Risk Management, and Quality Assessment and ... NYS licensure. + Five (5) or more years experience in either Utilization Management, Quality Assessment and Improvement, Risk Management, and/or Discharge Planning… more
- Highmark Health (Albany, NY)
- …**JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most ... URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team… more
- Elevance Health (New York, NY)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military ... and Experiences:** + Child and Adolescent experience strongly preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. For… more
- FLACRA (Clifton Springs, NY)
- …progress toward performance goals including length of stay, audit outcomes, and utilization rates. Reporting & Community Relations: + Maintain accurate and timely ... + Audit Scores: Maintain target scores in QCA and proactive audits + Bed Utilization : Maintain occupancy at or above 93% + Length of Stay: Average combined… more
- Parsons Corporation (New York, NY)
- …this level is a fully qualified and licensed professional, proficient in the utilization of engineering theories and practices. Some assignments involve the use of ... at this level is a fully qualified professional, proficient in the utilization of most engineering theories and practices.** **Some assignments involve CAE (computer… more
- CUNY (New York, NY)
- …counselors, and campus staff to track student progress, monitor program utilization , and assess effectiveness of student support activities. + Identify external ... of faculty, staff, and other service providers to monitor and assess utilization , student progress, and program effectiveness - Performs related duties as assigned.… more
- Centene Corporation (Queens, NY)
- …managed care or medical group experience, provider relations, quality improvement, utilization management, or clinical operations. Project management experience at a ... across multi-disciplinary teams. Highly proficient in HEDIS/Quality measures, cost and utilization .Pay Range: $86,000.00 - $154,700.00 per year Centene offers a… more
- Spectrum Health and Human Services (Rochester, NY)
- …of individuals and support self-advocacy + Assist in the development of and utilization of self-help tools if applicable. + Sharing personal experiences to build ... School Diploma or GED EXPERIENCE: + Preferred One-year work related system + Utilization of Electronic Data Systems + Lived experience in the Criminal Justice System… more
- Bassett Healthcare (Cooperstown, NY)
- …record keeping for patient's medical record, statistical information, radioactive utilization , and billing process + Responsible for supervising their individual ... all staff + Provides leadership and motivation to staff + Plans for utilization of staff working times, sets work schedules, defines duties, maintains effective… more
- Molina Healthcare (Rochester, NY)
- …of payment decisions. + Serves as a clinical resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. + ... ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review. + Minimum two years of experience in… more
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