- Project Renewal, Inc. (New York, NY)
- …in the development and implementation of quality assurance management and utilization review + Participates in interdisciplinary meetings with shelter ... and housing staff for the assigned site to discuss high risk patients + Participates in quality improvement initiatives + Participates in community outreach programs as needed + Contributes to the overall functioning of the department + Maintains patient… more
- University of Rochester (Brighton, NY)
- …billing and data reporting. Work with Strong Ties leadership and Dept of Psychiatry Utilization Review team to address documentations concerns in a timely way ... and problem-solving reduction in risk of noncompliance going forward. Prepares for and participates in regulatory surveys for ACT with the Strong Ties Leadership team and engages in the development, monitoring and evaluation of Performance Improvement Plans… more
- University of Rochester (Rochester, NY)
- …as required by third-party payors. Refers cases appropriately to physicians and Utilization Review for additional follow-up on medical information needed. + ... Interviews responsible parties to determine credit status as a tool for securing patient accounts. Verifies information collected. Maintains confidentiality of all patient information. + Exercises knowledge of sponsorship programs available to patients.… more
- Kaleida Health (Williamsville, NY)
- …2 years of experience In any combination of: case management, home care and utilization review preferred. Knowledge of and experience with Interqual Criteria set ... and software systems preferred. 2 years of experience of supervisory experience preferred.** Working Conditions **Job Details** Department: MFS Patient Management Standard Hours Bi-Weekly: 37.50 Weekend/Holiday Requirement: No On Call Required: No **With… more
- WMCHealth (Valhalla, NY)
- …patients; familiarity with the functions of hospital admitting, medical records and utilization review , particularly as they impact reimbursable costs; skill in ... making arithmetic computations; ability to interview patients and/or their families to be able to extract information about their medical coverage or eligibility; ability to plan and follow-up on payment schedules with patients on services determined as… more
- Cognizant (Albany, NY)
- …guidelines and regulations. * Experience in the analysis and processing of claims, utilization review /quality assurance procedures. * Must be able to work with ... minimal supervision. * Creative thinker with good skills a problem resolution specifically related to healthcare claim adjudication. * Possess ability to work at a computer for extended periods. * Can work closely with other departments **Required Education… more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …trends on a monthly basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates in, and attends ... various other committees of the Facility/Community (eg, Quality Assessment and Assurance) as required, and as directed by their supervisor and Administrator MDS Director RN Qualifications: + Registered Nurse with current, active license in state of practice. +… more
- New York State Civil Service (Buffalo, NY)
- …count and records.* Plan the layout of storage areas for safety and efficient utilization .* Review complaints and take appropriate action to resolve them.* Other ... duties as assigned.Outstanding Benefits PackageWorking at UB comes with benefits that exceed salary alone. There are personal rewards including comprehensive health and retirement plan options. We also focus on creating and sustaining a healthy mix of work,… more
- Wellpath (Valhalla, NY)
- …care through adherence to policies and procedures for admission and transfer, utilization review , and referrals. + Assumes responsibility and accountability for ... individual judgments andactions, andprovidesinput into mandatory committees as requested by superiors. **Qualifications & Requirements** Education + Graduation from an accredited nurse practitioner program. Experience + Two (2) years of experience as a Nurse… more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... sessions. + Collaborating with and informing facility staff in areas of patient progress. + Educating members of the team in areas of expertise. + Working with a facility to teach documentation practices which assist the respiratory therapy team. +… more