- Veterans Affairs, Veterans Health Administration (Potsdam, NY)
- …orientation, competencies and providing quality improvement and outcomes utilization . Demonstrates leadership in delivering and improving holistic, home-based ... subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested...registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement… more
- Cardinal Health (Albany, NY)
- …is to provide a detailed outline of clearance criteria as well as prior authorization and advocacy identification for procedures and medications scheduled to be ... representatives for benefit investigation as well as clinical clearance for prior authorization and medical necessity + Extensive patient education/counseling to… more
- L3Harris (Rochester, NY)
- …is aligned with business priorities and identify solutions for the optimal utilization of resources + Work cross-functionally with the various integration and test ... Bachelor's degree with a minimum of 15 years of prior relevant experience. Graduate degree with a minimum of...experience. Graduate degree with a minimum of 13 years prior related experience. In lieu of a degree, minimum… more
- Veterans Affairs, Veterans Health Administration (Syracuse, NY)
- …orientation, competencies and providing quality improvement and outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic ... subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested...registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement… more
- Molina Healthcare (NY)
- …Duties * Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional ... * Accurately enters approvals or denials of requests. * Facilitates prior authorization requests within established pharmacy policies and procedures. * Participates… more
- S&P Global (New York, NY)
- …contacts in wealth and investment management. You have working knowledge of-and prior experience in, index-based investing, ETFs, SMA and fund distribution. You have ... Americas, you will be responsible for regional initiatives that maximize product utilization and facilitate asset growth, ensuring that our solutions meet the… more
- University of Rochester (Rochester, NY)
- …for referral to hiring managers. + Determines eligibility for hire and rehire prior to referral to department manager. + Reviews personnel files and system records ... for prior employees to determine suitability for rehire. + Keeps...with appropriate recruitment sources for qualified and diverse candidates, utilization of a variety of effective advertising and social… more
- Molina Healthcare (NY)
- …for requested treatments and/or procedures. * Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. * Processes ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more
- Weill Cornell Medical College (New York, NY)
- …and eligibility verification for all appointments/procedures. Resolves registration issues prior to patient appointment to ensure smooth check-in. + Verifies ... insurance eligibility and obtains necessary pre-authorization numbers, if required, prior to appointment date. Facilitates the communication and collection of… more
- Highland Hospital (Rochester, NY)
- …insurance eligibility and coverage verification using the three patient identifiers, confirming prior authorization is on file for correct level of care, inquires on ... prior auth denials and works with the Provider's office...identifies and resolves coordination of benefits discrepancies, and notifies Utilization Management of additional clinical requests$19.62 - $26.49 an… more
Recent Jobs
-
Senior Software Development Engineer in Test (SDET)
- Space Dynamics Laboratory (Colorado Springs, CO)
-
Senior Manager, System Level Testing
- Cisco (San Jose, CA)