- Kaleida Health (Buffalo, NY)
- …In addition to daily oversight of operations, the VP will partner with Utilization Review , Revenue Cycle, and Clinical leadership to create patient/family ... preferred. RN licensure required.** **Experience** **10 years of care management/ utilization management experience required in hospital and/or ambulatory settings. 7… more
- FLACRA (Penn Yan, NY)
- …within the timelines outlined by FLACRA. + Participates in quality initiatives and utilization review activities as requested. + Strives to understand and meet ... the fiscal and financial parameters of practicing in the health care environment. + Provide administrative and/or clinical supervision to clinic staff as appropriate and in collaboration with clinic director. + Provides educational presentations and… more
- Calvary Hospital (Bronx, NY)
- …identify the expected length of stay (ELOS). The RNCM participates in the Utilization Review , Discharge Planning, Risk Management, and Quality Assessment and ... Qualifications: + Five (5) or more years experience in either Utilization Management, Quality Assessment and Improvement, Risk Management, and/or Discharge Planning… more
- Calvary Hospital (Bronx, NY)
- …pertinent data. 8. Knowledge of and experience in Quality Assessment and Improvement, Utilization Review . 9. Ability to develop management systems to track data ... has been denied. Conducts interdepartmental meetings related to the quality and utilization of clinical services. Serves on various Hospital committees as assigned.… more
- Mohawk Valley Health System (Utica, NY)
- …in all types of weather conditions. PREFERRED: + Experience in quality improvement and utilization review . + At least 2 years of case management or homecare ... completion and compliance under current guidelines. + Identify and review adverse outcomes for root cause. Review ...and review adverse outcomes for root cause. Review charts to ensure appropriate preventative measures and follow-ups… more
- Insight Global (New York, NY)
- …preferred - 5-6+ years of clinical practice can be flexible - 1+ years of utilization review experience in a managed care plan (health care industry) - Licensed ... Physician Reviewers for a leading health insurance company. The Physician Reviewer will review requests for care before, during, and after treatment to confirm they… more
- STG International (Auburn, NY)
- …safety. * Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... of Quality Performance Improvement Team (QPIT) strategic initiatives. * Participate in review and improvement of clinical success in of areas of responsibility. *… more
- WellLife Network (South Richmond Hill, NY)
- …location and schedules are subject to change. 5. Attend certification inspections, utilization review and independent professional reviews as needed. 6. Attend ... medical pre-admission evaluations and screening of prospective clients. 2. Review and update persons with disabilities pre-admission evaluation within thirty… more
- New York State Civil Service (NY)
- …research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or ... as a member of an interdisciplinary treatment team and attend meetings for case review ; * Participate in and lead individual, family and group counseling sessions; *… more
- STG International (Kingston, NY)
- …safety. + Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... of Quality Performance Improvement Team (QPIT) strategic initiatives. + Participate in review and improvement of clinical success in areas of responsibility. +… more