- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, process and procedures ensuring accurate member care ... responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include the supervision… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include the supervision… more
- Elevance Health (New York, NY)
- …+ Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate on committees or in ... and providers. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology regimens and… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...patients who were readmitted within thirty days. Documents over utilization of resources and services. + All Medicare cases… more
- New York State Civil Service (Albany, NY)
- …Programs; Actively participating in various committees, including the Drug Utilization Review Board, Provider Enrollment Appeals Committee, Evidence-Based ... Benefit Review Advisory Committee, Irregular Billing Committee, Utilization Review Edit Committee, Quality Improvement Committee, Physician Administered… more
- Highmark Health (Albany, NY)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most… more
- New York State Civil Service (Newburgh, NY)
- …experimental psychology, research psychology, industrial psychology, organizational psychology, utilization review , guidance counseling, etc.Psychologist 2:You ... psychology, research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or… more
- WMCHealth (Margaretville, NY)
- …admission medical records. + UR-Reports concerns re: admissions and continued stay to Utilization Review Chair person and Medical Director. + UR- Prepares ... selected patients across the health care continuum. Promotes effective utilization of resources and the highest quality of care...monthly statistical report for monthly review at the UR Committee meeting. + UR-Provides clinical… more
- New York State Civil Service (Binghamton, NY)
- …and clinical staff on health information management requirements.* Conducting audits for utilization review activities and reporting deficiencies to the ... Utilization Review Committee.* Implementing corrective actions as determined by internal and external audit findings.* May supervise lower-level clerical and… more
- Crouse Hospital (Syracuse, NY)
- …requirements related to acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical, Dental, Vision, FSA, ... day management of the RN Care Managers in the department, including Utilization Management, Discharge Planning and Denials and Appeals functions. + Assessing… more