- 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
- Stony Brook University (Stony Brook, NY)
- …Required to perform Donor and Therapeutic Apheresis as assigned.. + Perform blood utilization quality assurance, donor related work as assigned. + Required to cover ... education and instructions are consistent with that of the physician or designee. + Communicates and works effectively with...or for a maximum of 90 days. An initial review of all applicants will occur two weeks from… more
- Stony Brook University (Stony Brook, NY)
- …with team, monitors mental status and reports progress or changes routinely to nursing/ physician staff. + Takes a primary role in maintaining a safe, therapeutic ... interventions, restraint/seclusion, behavior plan development and safety plan development, utilization and monitoring. + Conducts a variety of patient...or for a maximum of 90 days. An initial review of all applicants will occur two weeks from… more
- CDPHP (Latham, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and ... for a rewarding career. Established in 1984, CDPHP is a physician -founded, member-focused, and community-based not-for-profit health plan that offers high-quality… more
- Catholic Health Services (Melville, NY)
- …timely follow through. + Reviews providers' requests for services and coordinates utilization /appeals management review . + Assist Utilization and Appeals ... as a liaison between patient account services, physicians, care coordinators, Utilization and Appeals Managers, physician advisors and facility departments.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member… 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
- CDPHP (Latham, NY)
- …for a rewarding career. Established in 1984, CDPHP is a physician -founded, member-focused, and community-based not-for-profit health plan that offers high-quality ... to be a part of that experience. The BH Utilization Specialist is responsible for coordination of care for...Certified Case Manager (CCM) designation preferred. + PRI (Patient Review Instrument) certification preferred. + Minimum one (1) year… 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
- Catholic Health Services (Melville, NY)
- …Initiatives + Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical ... presents to Physician Advisors during the monthly Physician Advisor meeting. + Attends hospital Utilization ...+ Certification by American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) preferred. 4. Knowledge,… more
