- Evolent (Albany, NY)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Director you will be a key member of the utilization management team. We can offer you a meaningful...and management staff, other Physicians, and staff whenever a physician `s input is needed or required. As well as,… more
- Mount Sinai Health System (Long Island City, NY)
- …interprets the clients responses to the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion but not less than ... to established standards as part of initial orientation and annual performance review with collaborating physician or appropriately credentialed designee. +… more
- Rochester Regional Health (Rochester, NY)
- …of patients across the continuum. + Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care based on medical ... necessity in the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization , performing continued stay… more
- Highmark Health (Buffalo, NY)
- … physician reviewer assignments for medical management decisions. Cases requiring physician review are provider and member requests, received from Medical ... agencies' standards including the National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Committee (URAC), Pennsylvania Department of… more
- Catholic Health Services (West Islip, NY)
- …hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. We are committed to caring for Long Island. Be ... The Associate Chief Medical Officer at Good Samaritan University Hospital is a physician who possesses a current, unrestricted license to practice medicine in the… more
- 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
- CenterWell (Westbury, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- Crouse Hospital (East Syracuse, NY)
- …- a OBGYN office with six providers and GYN office with one Physician . Plans, develops, organizes, monitors and manages all protocols and activities to improve ... patient access and care. Ensures efficient utilization of all resources. Provides leadership, supervision and motivation of all staff. Works collaboratively with all… more
- Mount Sinai Health System (New York, NY)
- …The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse, Physician Assistant, or Nurse Practitioner, who manages the 24 hour a day ... patient-centered care. **Qualifications** Must be a Licensed Registered Nurse, Physician Assistant or Nurse Practitioner Registered Nurse Bachelor?s Degree in… more
- Catholic Health Services (Melville, 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 ... The ProFee CDS will focus on pre-visit provider support, post-visit provider review , and collaboration and education with providers. Pre-visit provider support -… more
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