- Elevance Health (New York, NY)
- …+ Determines the medical necessity of requests using clinical criteria. + Performs physician -level case review of musculoskeletal utilization requests. + ... PM Central** **Virtual:** This role enables associates to work virtually full -time, with the exception of required in-person training sessions, providing maximum… more
- Spectrum Health and Human Services (Buffalo, NY)
- …and support to achieve self-defined improvements in their quality of life. Full -time: 1298 Main Street, Buffalo, NY SUMMARY OF POSITION FUNCTION: The Care ... Care Coordinator will be responsible for the following outcomes: to reduce utilization associated with avoidable and preventable inpatient stays, to reduce … more
- Kaleida Health (Buffalo, NY)
- …conventions and insurance / managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG denial management required. ... Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full -Time **Shift:** Shift 1 Job Description **Summary:** The Director, Clinical & DRG… more
- Rochester Regional Health (Rochester, NY)
- …Life Support (BLS) certification PREFERRED QUALIFICATIONS + Acute care, chart review , utilization , or nursing triage experience strongly preferred. EDUCATION: ... to improve clinical practice. * Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research… more
- WMCHealth (Kingston, NY)
- …NY Category: Allied Health Prof/Technical Department: Physical Therapy Union: No Position: Full Time Hours: T-S Shift: Day, Evening Req #: 40053 Posted Date: ... functional evaluation of the client; conducts the planning and utilization of a program of purposeful activities; implements the...be rendered on the prescription or referral of a physician , nurse practitioner or other health care provider acting… more
- University of Rochester (Rochester, NY)
- …welcoming to all and is a place where all can thrive. **Job Location ( Full Address):** 601 Elmwood Ave, Rochester, New York, United States of America, 14642 ... **Opening:** Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500183 Health...feedback on evaluations for direct and indirect reports. + Review and evaluate proposed promotions or terminations as appropriate.… more
- Veterans Affairs, Veterans Health Administration (Batavia, NY)
- …Part II, Appendix G. The Advanced MSA coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization ... the advanced performance level for a Medical Support Assistant (MSA), performing a full range of duties in Health Administration Service at VA WNY Healthcare System,… more
- CVS Health (Albany, NY)
- …we collaborate with members, providers, and community organizations to address the full continuum of our members' health care and social determinant needs. Join ... meal delivery, assists with securing DME, and helps to ensure timely physician follow-up. - Understands Payer/Plan benefits, policies, procedures, and can articulate… 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
- YesCare Corp (Coxsackie, NY)
- …measures including sentinel event review . + Actively participant of the Utilization Review process and follow proper procedures. + Provides appropriate ... in-service education of staff as requested. Participates in monthly review of quality of care and chart reviews as...quality of care and chart reviews as requested. Sponsors physician assistants or nurse practitioners as required. + Notifies… more