- Calvary Hospital (Bronx, NY)
- …8. Knowledge of and experience in Quality Assessment and Improvement, Utilization Review . 9. Ability to develop management systems to track data over time. ... has been denied. Conducts interdepartmental meetings related to the quality and utilization of clinical services. Serves on various Hospital committees as assigned.… more
- Guthrie (Corning, NY)
- …and autonomy in nursing practice. Preferred experience with PCMH process, care management / utilization review , and payer knowledge. Fast paced ambulatory ... Coordinator has the responsibility and accountability for coordinating the medical management of patients, using an outcomes‐based approach. In collaboration with… more
- The New Jewish Home (Bronx, NY)
- …informed of the latest internal and external issues and trends in utilization and quality management through select committee participation, networking, ... staff as required. o Leads the quality assessment, quality program management and quality 2. Performance improvement strategies for TNJH in collaboration… more
- Molina Healthcare (Rochester, NY)
- **Job Summary** **_For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of KENTUCKY or have a compact license._** Provides ... claims data to ensure appropriate payment levels, optimize resource utilization , and maintain compliance with state and federal laws....focus on promoting the quality, accuracy, and efficiency of review services. + Serve as a resource and subject… more
- Arnot Health (Bath, NY)
- …Term Care staff, attends weekly care conference meetings, and weekly Medicare A review with care team and therapies. + Demonstrates effective time management , ... of the Long Term Care Department. + Ensures the utilization of the nursing process in maintaining quality of...resident care. e. Assists the DON with implementing appropriate review systems for competency-based appraisals of staff. f. Participates… more
- MVP Health Care (Tarrytown, NY)
- …every interaction **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes ... + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management ...with an established interdisciplinary team. + The role requires review of a comprehensive assessment and development of a… more
- UHS (Johnson City, NY)
- …and accountability through Just Culture principles. This role collaborates with nurse managers, physicians, and administrative leaders to lead strategic planning, ... to learn more. Position Responsibilities + Communication and Relationship Management : + Builds Collaborative environments by developing trusting relationships… more
- Mohawk Valley Health System (Utica, NY)
- …regulatory compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review /case management experience or social work ... Case Manager - Full Time - Days Department: CASE MANAGEMENT Job Summary Reports to and is under direct...filed. + Bachelor's degree is preferred. + Licensed professional nurse may be considered. + Bachelors or Masters Degree… more
- Fresenius Medical Center (New York, NY)
- …barriers to quality improvement. This includes promoting the adoption and utilization of Medical Advisory Board Recommended Algorithms and Standing Orders, clinical ... quality improvement tools and electronic applications. + Performs desk review of facility Quality Assessment and Performance Improvement (QAPI) documentation… more
- Guthrie (Binghamton, NY)
- …Summary: Provides clinical and administrative leadership and is responsible for the management of the assigned nursing division. The Director of Nursing is ... accountable for the management of patient care, human, fiscal and material resources...role in staffing and scheduling of personnel, considering appropriate utilization of personnel, scope of practice, competencies, patient needs… more