- Elevance Health (New York, NY)
- …necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts peer-to-peer ... advanced practice nurses regarding established guidelines and accepted standards of care as it relates to treatments, surgical procedures, imaging and appropriate… more
- University of Rochester (Rochester, NY)
- …Clinical Materials Services Unit (CMSU). **ESSENTIAL FUNCTIONS** Quality Assurance Review and Verification of Production Operations + Oversees production receiving ... and packaging components to pre-approved specifications. + Incoming inspection and review of all labeling, drug products and components documentation for conformance… more
- Access: Supports For Living (Howard Beach, NY)
- …other entities as required (OPWDD 147 form, etc.) + Support appropriate budget utilization : Review expenditures for overage issues and address such issues with ... Essential Functions: + Oversee a caseload of 60-80 participants + Review , upload and approve budget, budget amendments/CNBAs/Annual Rollovers within eVero portal.… more
- WellLife Network (South Richmond Hill, NY)
- …location and schedules are subject to change. + Attend certification inspections, utilization review and independent professional reviews as needed. + Attend ... along with Client Coordinator. + Act as a medical resource person for Residence Manager and staff to ensure proper medical care and follow through on… more
- CenterWell (Albany, NY)
- …+ Monitor plan performance and proactively bring issues to the forefront for review + Support new business implementations with a goal of ensuring all pharmacy ... and present to client + Escalate issues for immediate review and action whenever necessary + Request, review...internal partners and the Medicaid market to manage pharmacy utilization and spend + Manage escalated member, client and… more
- CVS Health (Farmingdale, NY)
- …your understanding of patient safety and error prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding ... of continuous improvement, with the goal of changing health care for the better. **Position Summary:** At CVS Health,...+ Any additional tasks as directed by Supervisor or Manager **Preferred Qualifications:** + 1+ years of related work… more
- Sharecare (Albany, NY)
- …individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit www.sharecare.com ... in an appropriate, efficient and cost-effective manner while ensuring high quality care . The Disease Management Nurse works with participating members to become… more
- RiseBoro Homecare Inc. (Brooklyn, NY)
- …information and referrals to clients as needed + Assist clients with medication review and understanding directives from Primary Care Physicians (PCPs) in order ... include: + Serve as part of a team comprised of Case Manager , Health Services Coordinator, and program supervisors to serve frail previously homeless… more
- Mohawk Valley Health System (Utica, NY)
- …+ Participates in appropriate agency meetings and the quality improvement and utilization review activities of the organization. + Supports the Agency's ... home health patient. Collaborates with the patient's primary case manager and other members of the health care team. Makes and documents home care nursing… more
- Albany Medical Center (Albany, NY)
- …We offer a friendly team-oriented work environment centered on efficient, compassionate patient care . The Ambulatory RN may provide direct patient care , patient ... triage, assessment, planning and evaluation of a patient's specific care . The Ambulatory RN collaborates with other members of...practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN), the RN may… more