- Rochester Regional Health (Rochester, NY)
- …able to work independently with minimum direction. + Act as a resource for utilization review stakeholders and assists team members in clinical problem solving. ... Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per...to payers/audits. + Participates in periodic denial meetings with Physician Advisors to review the denials that… more
- Evolent (Albany, NY)
- …mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Utilization … more
- Highmark Health (Albany, NY)
- …determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by ... the physician against medical policy criteria. The incumbent then uses...prior authorization or appeals against medical policy through the Utilization Review system. Update the system records… more
- Ellis Medicine (Schenectady, NY)
- …of Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending physician for additional information if the ... the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration...of discharge plan + Collaborates and makes referrals to physician advisor when unable to resolve issues with attending… more
- Mohawk Valley Health System (Utica, NY)
- …specialist regarding correct level of care and reimbursement. Apply knowledge of utilization review , discharge planning, patient status changes, length of stay, ... billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of...and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Exciting Opportunity for OR-Experienced Physician Assistants!** Join The Mount Sinai Hospital and become an operational leader. Gain hands-on ... with this incredible opportunity! The Program Director is a credentialed Physician Assistant (PA), responsible for daily operations of _all_ surgical sub-specialties… more
- New York State Civil Service (West Haverstraw, NY)
- …care and high-quality clinical outcomes. Participation in quality improvement, utilization review , and clinical documentation integrity initiatives. Willingness ... Yes Agency Health, Department of - Helen Hayes Hospital Title Clinical Physician 2 (NY HELPS) Occupational Category Health Care, Human/Social Services Salary Grade… more
- UHS (Norwich, NY)
- …for patient/provider phone calls. + Creates a system for monitoring clinic utilization , workload vs. billing, and individual physician provider productivity on ... Position OverviewThe Director of Physician Practice Operations is responsible for the workflow...you grow wherever your passion leads. We also continuously review compensation to ensure market competitiveness and internal equity,… more
- BriteLife Recovery (West Kill, NY)
- …Maintain compliance with regulatory, licensing, and accreditation standards (eg, audits, utilization review , quality assurance). + Participate in performance ... Physician Assistant Do you work for a company...place to work. What you will be doing? The Physician Assistant (PA) at Britelife Recovery plays a critical… more
- New York State Civil Service (West Haverstraw, NY)
- …care and high-quality clinical outcomes. Participation in quality improvement, utilization review , and clinical documentation integrity initiatives. Willingness ... Yes Agency Health, Department of - Helen Hayes Hospital Title Clinical Physician 2 Occupational Category Health Care, Human/Social Services Salary Grade 36… more