- Catholic Health Services (Rockville Centre, NY)
- …hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health, our primary focus is the ... resources to patients and/or their caregivers. Responsible for accurate and timely review of discharged medications in the acute care areas. Interviews patients,… more
- New York State Civil Service (Syracuse, 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
- Evolent (Albany, NY)
- …quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on ... Medical Director direction, using independent nursing judgement and decision-making, physician -developed medical policies, and clinical decision-making criteria sets. Acts… more
- UHS (Johnson City, NY)
- …clerical work + Previous experience in data processing + Certified home care and/or utilization review work experience Why You'll Love Working at UHS At United ... communication skills and a thorough understanding of insurance requirements. You'll review clinical documentation to confirm it meets agency and payer standards… more
- WMCHealth (Valhalla, NY)
- …experience in a hospital setting, preferably cardiology, radiology, surgery or utilization review , required. Previous revenue integrity experience, Excel and ... payors. + Develop, Implement and coordinate billing practices between hospital and physician groups to ensure uniform coding and documentation. + Recommend sound… more
- Stony Brook University (Commack, NY)
- …improvement and monthly/quarterly outcome reporting. + Conduct regular drug utilization reviews (DUR), controlled substance audits, prescriber reviews and other ... and other formulary rules. + As a designee for the Director, review prior authorizations in accordance with Program criteria. Ensure all formulary protocols… more
- CDPHP (Albany, NY)
- …care pharmacy principles including prior authorization reviews, formulary management, and utilization review preferred. + Experience with Microsoft Office, ... 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
- Veterans Affairs, Veterans Health Administration (Syracuse, NY)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... the phone. When consults are in a "scheduled status", the Advanced MSA will: Review the Vista Image Display to determine, If the records have previously been… more
- New York State Civil Service (Claverack, NY)
- …research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or ... health and substance use screens, youth and collateral interviews, and record review to develop a psychosocial assessment and subsequent mental health treatment… more
- STG International (Watertown, NY)
- …* Design and participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... and participate in the recruitment, and orientation of clinical staff physicians, physician assistants and nurse practitioners. * Collaborate with the CBOC Clinic… more