- Catholic Health Services (Melville, NY)
- …The ProFee CDS will focus on pre-visit provider support, post-visit provider review , and collaboration and education with providers. Pre-visit provider support - ... indicators + Validation of data-driven suspect diagnoses Post-visit provider review - Perform post-visit reviews focused on what is...Certification: CCS-P, CPC, CRC, or other coding credential + RN or LPN helpful but optional + Extensive clinical… more
- St John's Community Services (Ithaca, NY)
- …11-bed residential facility. Activities include clinical supervision, plan development, review of client records/notes, program planning and group facilitation. Your ... + Ensures the development and maintenance of treatment plans. + Performs review and supervisory maintenance of official records including treatment plans, progress… more
- Rochester Regional Health (Rochester, NY)
- …for quality initiatives, collaborates with CNO/Director of Quality to provide quality review activities. Guides assigned areas in utilization of recognized ... Health Professional or OASAS Qualified Health Professional who hold Master's degree; or RN BSN with minimal 3 years clinical experience; or Similar combination of… more
- Evolent (Albany, NY)
- …mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance ... for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices...UM to ensure client satisfaction. Perform all peer clinical review activities while located in a state or territory… more
- Elevance Health (Middletown, NY)
- …and outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses appropriate screening ... equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC LPC LBA (as allowed by...is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …by Administration. **Qualifications** **Education:** + Licensed Masters Social Work required or + Registered Professional Nurse required. + RN must be ... Responsible for planning and implementation of services to drive utilization of the Kinney Home Services program. + Proactively...the program. + Attends discharge meetings as necessary to review areas of concern and create plans for resolution.… more
- Elevance Health (Latham, NY)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
- US Tech Solutions (Tarrytown, NY)
- …initiatives. - Lead material resource selection, standardization, price optimization and utilization initiatives while promoting and utilizing Value Analysis in the ... in the development and ongoing improvement of new product review and approval process, and assist in identifying and...equivalent combination of education and experience such as MD, RN , PA, CNA or LPN/LVN . Minimum of seven… more
- Bowery Residents Committee (Manhattan, NY)
- …assessments, evidence-based treatment plans, and crisis intervention. Gather and review documentation as requested for utilization management reviews ... completion of LOCADTRs. Participate fully in a multidisciplinary team including MD, RN , LPN, CASAC, LMHC, Peer specialists and LCSW. Provide emergency first aid/CPR… more