- New York State Civil Service (New York, NY)
- …Law Article 15-A and related regulations, and the MWBD Division, concerning the utilization of certified MWBEs on state contracts. Duties include but are not limited ... to assigned agencies/authorities.* Receive, analyze, and evaluate, and conduct primary review and take corrective actions on agency/authority annual goal plans and… more
- Humana (Albany, NY)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all… more
- J&J Family of Companies (Rochester, NY)
- …development and clinical success, including procedure sales, support and driving utilization for all Auris Surgical Robotics Technologies. The Field Sales Account ... part of the sales process, referral education sales activities, conducting Business Review Program sessions, managing any post sales installation and will support… more
- Humana (Albany, NY)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Evolent (Albany, NY)
- …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- University of Rochester (Rochester, NY)
- …Identifies problems that include but are not limited to pre-certifications, Utilization Management, Medicaid Pending, third party payer issues, and denials/appeal ... and follow-up with assigned area, Financial Assistance, Social Work, Utilization Management, Medicaid Enrollment & Outreach, patients, families, third-party payers,… more
- Highmark Health (Albany, NY)
- …business relationships, the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The role involves ... units that may assist in the resolution of issues or problems. + Access, review , utilize, contribute content to and participate in the maintenance of the shared… more
- WMCHealth (Valhalla, NY)
- …and logistics framework. Responsibilities: . Leads the development, implementation and review of an optimal inventory strategy to ensure the appropriate balance ... of service, quality cost and access are maintained. . Manages the effective utilization of existing warehousing and inventory facilities across the network . Drives… more
- Mount Sinai Health System (New York, NY)
- …interprets the clients responses to the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion but not less than every ... and other health team members. + Participates in peer review . + Incorporates research findings in clinical practice. +...Ability to interpret and apply principles of nursing research utilization . + Ability to manage and coordinate a patient… more
- Mount Sinai Health System (New York, NY)
- …the clients responses to the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion but not less than every ... and other health team members. 6. Participates in peer review . 7. Incorporates research findings in clinical practice. 8....Ability to interpret and apply principles of nursing research utilization . 5. Ability to manage and coordinate a patient… more