- CDPHP (Latham, NY)
- …clear understanding of prescription and medical benefits as it applies to the utilization review process. + Must demonstrate proficient experience with the ... 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
- Elevance Health (New York, NY)
- …Medical Director** **Carelon Medical Benefits Management** **Radiology Benefit Management/ Utilization Review ** **Virtual:** This role enables associates ... case reviews for their board certified specialty. + Makes physician to physician calls to gather medical...decisions. + Brings to their supervisors attention, any case review decisions that require + Medical Director review… more
- Independent Health (Buffalo, NY)
- …**Overview** The Clinical Reviewer will be responsible for the collection and review of medical records specific to quality complaints/grievances and appeals as ... indicated in support of a high performing health plan and physician network. The Clinical Reviewer will investigate quality complaints/grievances and appeals,… more
- Arnot Health (Elmira, NY)
- …Bachelor's in nursing preferred. Must have proficient writing skills.Experience in Utilization Review and InterQual required. CARDIOPULMONARY RESUSCITATION (CPR) ... of auth/denial review decisions. 8. Maintains a working relationship with Physician Advisor regarding physician issues related to auths/denials. 9. Provide… more
- WellLife Network (South Richmond Hill, NY)
- …location and schedules are subject to change. + Attend certification inspections, utilization review and independent professional reviews as needed. + Attend ... medical pre-admission evaluations and screening of prospective clients. + Review and update persons with disabilities pre-admission evaluation within thirty… more
- Albany Medical Center (Albany, NY)
- …Salary Range: $83,200.00 - $128,960.00 Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse ... to patients in clinic, under the direction of a physician or APP + Participates in in-office procedure, as...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
- Albany Medical Center (Albany, NY)
- …Salary Range: $83,200.00 - $128,960.00 Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse ... to patients in clinic, under the direction of a physician or APP + Participates in in-office procedure, as...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
- Albany Medical Center (Albany, NY)
- …on efficient, compassionate patient care. Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse ... to patients in clinic, under the direction of a physician or APP + Participates in in-office procedure, as...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
- Albany Medical Center (Albany, NY)
- …of HIV and those at risk for HIV. Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse Manager (RN) ... to patients in clinic, under the direction of a physician or APP + Participates in in-office procedure, as...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
- Albany Medical Center (Albany, NY)
- …dynamic, quality focused, team-based department. Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision of the ... to patients in clinic, under the direction of a physician or APP* Assesses and documents response to medication...in EHR* Performs venipuncture per order of MD/APP* Performs review and triage of incoming test results, patient requests… more