- 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
- Guthrie (Binghamton, NY)
- …leadership role in staffing and scheduling of personnel, considering appropriate utilization of personnel, scope of practice, competencies, patient needs and ... collaborative relationship with Clinical Coordinators, meeting on a regular basis to review goals, needs, and expectations for managing the unit on a 24/7… more
- Guthrie (Corning, NY)
- …and autonomy in nursing practice. Preferred experience with PCMH process, care management/ utilization review , and payer knowledge. Fast paced ambulatory care ... for all identified patients. + e. Collaborates with patient, physician , and other care team members in assessing the...Employer. The Guthrie Clinic is a non-profit, integrated, practicing physician -led organization in the Twin Tiers of New York… more
- Northwell Health (Staten Island, NY)
- …Case Manager - FlexStaff Serves as liaison between the patient and facility/ physician . Ensures a continuum of quality patient care throughout hospitalization and ... + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria + Submits… more
- Veterans Affairs, Veterans Health Administration (Bronx, NY)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities The James J Peters VAMC is seeking a Full -Time Staff Pathologist. The JJP Pathology and Laboratory Medicine Service (PALMS) encompass the health… 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 (Hauppauge, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... and help us put health first** **Work Schedule** : Full -time/40 Hours **Position Type** : On-site **Branch Location** :...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- Veterans Affairs, Veterans Health Administration (Bronx, NY)
- Summary The James J Peters VAMC is seeking a Full -Time Hospitalist Section Chief and Director of Inpatient Quality who will direct patient care and support a range ... care for medical inpatients. General Management of Hospitalist Team: Review relevant Internal Medicine Service performance measures, OPPE/FPPE, performance pay,… more
- Humana (Albany, NY)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Humana (Albany, NY)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more