- 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
- Claxton-Hepburn Medical Center (Ogdensburg, NY)
- …Planner-Full Time- Day Shift- Req 8830 Pay Range: $30.60-$40.54 Job Summary: The Utilization Review (UR) and Discharge Planner will assist in maintaining the ... medical records. + Report on insurance authorizations and denials to the Utilization Review Committee and the Department of Psych. + Coordinate, educate, and… more
- New York State Civil Service (Rochester, 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
- Highmark Health (Albany, NY)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
- CDPHP (Albany, NY)
- …clear understanding of prescription and medical benefits as it applies to the utilization review process. + Must demonstrate proficient experience with the ... pharmacy tech will participate in an on-call/holiday rotation along with a utilization management pharmacist to support Plan members in after hour pharmacy issues.… more
- Mount Sinai Health System (Long Island City, NY)
- …Description** The Director will direct and manage departmental activities involved in utilization review , appeals management and discharge planning to facilitate ... other services by focusing on patient processes. 8.Develops and implements Utilization Review (UR) based on internal data collection, data received from external… more
- New York State Civil Service (Orangeburg, 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
- Stony Brook University (Stony Brook, NY)
- …use of resources. + Oversee staff performance including new staff orientation + Knowledge of Utilization Review and LOS + Review of high-risk complex cases. ... or for a maximum of 90 days. An initial review of all applicants will occur two weeks from...full consideration, applications must be received before the initial review date (which is within two weeks of the… more
- CVS Health (Albany, NY)
- …with transferring patients to lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC recognized accreditation preferred - 1+ ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- CVS Health (Albany, NY)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more