- Sedgwick (Albany, NY)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS** **Education & Licensing** Bachelor's degree from an accredited college or university preferred.… more
- Nuvance Health (Carmel, NY)
- …years RN experience in an acute care setting; Leadership experience preferred; Utilization review , discharge planning or case management experience preferred. ... Location: Carmel-PHC 670 Stoneleigh Avenue Work Type: Full-Time Standard Hours: 37.50 FTE: 1.000000 Work Schedule: Day 10 Work Shift: This is a Monday thru Friday position with rotating weekends. 8am-4pm Org Unit: 1168 Department: Care Coordination Exempt: Yes… more
- Garnet Health (Harris, NY)
- …Manager for the detox patient on the medical floor assuring discharge planning, utilization review , and insurance approval. At Garnet Health, we are committed ... to supporting your career growth and professional potential. We are responsive, attentive and dedicated to the success and satisfaction of our team members. Here, you'll find resources that will help you excel in your career, tuition reimbursement programs for… more
- Albany Medical Center (Albany, NY)
- …field of Clinical Social Work or Nursing with experience in Case Management, Utilization Review and Discharge Planning. * BLS Certification. * Demonstrated ... clinical competency in a nursing or allied health specialty. Previous experience in education program development and teaching preferred. * Ability to create collegial and collaborative relationships internally and externally. * Ability to read and analyze… more
- Catholic Charities Family Community Services (Rochester, NY)
- …periodic updates and a closing letter. + Provides information for HMO and payer utilization review as required. + Participates in staff meetings and clinical ... supervision as determined by supervisor. + Informs supervisor of significant events/issues related to clients as appropriate, and follows program's defined incident reporting process as required. + Maintains current knowledge on professional practice through… more
- SUNY Upstate Medical University (Syracuse, NY)
- …work with clinicians regarding patient deaths and completion of DAVE. Work with Utilization Review department to ensure correct patient class & status changes ... in EPIC for patients inhouse or recently discharged. Will be responsible for the securing and releasing of inhouse patient's valuables in the hospital safe. Minimum Qualifications: Associates degree and three years relevant experience in a health care setting… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …accreditation standards pertaining to its state licensure, third party administrators, utilization review and management requirements. The Manager of Compliance ... and Clinical Operations will also have oversight of HealthDirect's clinical operations and will be responsible for ensuring that clinical standards are strictly managed and adhered to at HealthDirect. **Responsibilities** + Partners with internal and external… more
- WellLife Network (Bronx, NY)
- …review goal progress, identify participant needs and update program plan and / or utilization of review plans. + Represent the program and the agency at ... personalized treatment plan. Assist in the completion of documentation and the review of case records. ESSENTIAL RESPONSIBILITIES: + Intake assessment of all… more
- City of New York (New York, NY)
- …and system concerns and issues to the Assistant Program Manager to ensure effective utilization of resources. - Review and audit selected records of two to ... as Fair Hearing Process Coordinators in the Fair Hearing Tracking Monitoring and Review Unit (FHTMRU). FHTMRU comprises of the Centralized Fair Hearing Aid to… more
- Catholic Health Services (Melville, NY)
- …Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and appeals ... for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of...care to MCC in response to physician order, or review of updated clinical information Acts as a resource… more