- 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
- Datavant (Albany, NY)
- …software tools. The specialist serves as a key liaison between coding, billing, utilization review , case management, and payer relations to reduce denials and ... + Previous experience with revenue integrity functions in a hospital or large physician group setting. + Familiarity with DRG and APC reimbursement methodologies. +… more
- Rochester Regional Health (Rochester, NY)
- …of the Medical Management Department to maintain daily operations. Oversees the daily review process of the third party payors ensuring information is tracked and ... maintained. Creates departmental reports for senior management. RESPONSIBILITIES + Oversees the review process of third party payors with oversight from the Director… more
- UHS (Norwich, NY)
- …Services policy + Shares responsibility for productivity and effective resource utilization including staffing, time management, supplies, and services + Complies ... Unit Council, participating in improvement initiatives, and contributing to peer review practices + Actively engages in professional development, continuing nursing… more
- New York State Civil Service (Lansing, 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
- New York State Civil Service (Albany, NY)
- …experience include but are not limited to: Experience in discharge planning, utilization review , treatment plan development for individuals in community or ... of procurement documents, preparing information and documents for internal/external review and/or presentation, and development of supporting documents for the… more
- Mount Sinai Health System (New York, NY)
- …the system on all matters related to medical staff governance, credentialing, peer review and performance management; + In collaboration with the FPA, Development of ... a system-wide physician orientation program, and a streamlined onboarding and recruitment...providers; + Development and maintenance of a system peer review process that is inclusive of all matters related… 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
- STG International (Kingston, 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 Clinic Manager… more
- UHS (Norwich, NY)
- …Services policy + Shares responsibility for productivity and effective resource utilization including staffing, time management, supplies, and services + Complies ... Unit Council, participating in improvement initiatives, and contributing to peer review practices + Actively engages in professional development, continuing nursing… more