- Northwell Health (Melville, NY)
- …level of care decisions and billing status and ensures compliance with the Utilization Review standard and regulations. + Performs concurrent and retrospective ... experience; 4+ years preferred. + Prior Acute Case Management and/or Utilization Review experience, preferred. + Must have experience with Milliman Care… more
- Access: Supports For Living (Middletown, NY)
- Clinical Quality Improvement Specialist - $1,500 Sign-On Bonus Location: Middletown, NY, United StatesDate Posted: Dec 11, 2025 Share: share to e-mail Apply Now Save ... and paper, and ensures follow through to close audit. + Conducts Utilization Reviews, electronically and paper, and ensure follow through. + Collaborates with… more
- MVP Health Care (Rochester, NY)
- …+ Assist with data entry, reporting, and tracking patient transitions and utilization metrics. + Review documentation for completeness ensuring compliance (eg: ... To achieve this, we're looking for an **Associate, Post-Acute Clinical Support Specialist ** to join #TeamMVP. If you have a passion for enhancing patient… more
- Abbott (New York, NY)
- …certified on EP products. + Requires a minimum of 6 months in Clinical Specialist position. + Minimum of 2 years clinical experience (internal or external with ... + Achieves or exceeds expectations in most recent performance review . + Requires an average of 15+ cases a...over last 6 months). + Demonstrate ability to increase utilization of Abbott Advanced Mapping and Ablation Tools. +… more
- CDPHP (Latham, NY)
- …invites you to be a part of that experience. The clinical support specialist (CSS) provides administrative support to clinical staff within Member Health. The CSS ... (2) years experience in a health insurance related discipline required. + Utilization management experience is preferred. + Knowledge of managed care, health plan… more
- Northwell Health (Manhasset, NY)
- …and research. + Develops and monitors the hospital's policies/procedures regarding utilization of medications in collaboration with the medical staff, Pharmacy, and ... Therapeutics Committee; monitors medication utilization effectively and intervenes when necessary to ensure compliance. + Ensures the safe and effective use of… more
- Brookfield Properties (Bronx, NY)
- …all verifications, certifications, and affidavits. Verify all income and assets, review documents for completeness and accuracy and clarify information, if ... income from assets. Submit the file to Compliance for review . Ensure corrections are made timely and that the...Oversees and ensures timely input, proper use and full utilization of on-site PC-based property management software systems including… more
- Citigroup (New York, NY)
- …drivers for assigned parts of the pillar portfolio, including assets, facility utilization , spreads, attrition, revenues, etc. Client & Sales Support + Support the ... concerns, etc. to region and global pillar head. + Support the Global Deal Review process by ensuring guidelines and criteria followed on new and Renewal items.… more
- Resource Center for Independent Living (Utica, NY)
- …various EEO, Labor Law and other statistical reports through the use ADP. + Review the ADP portal regularly for updates and take ADP training courses regularly to ... transfer paperwork. + Distribute and track internal employee electronic annual training and utilization on the Agency training portal. + Assist in maintaining all HR… more
- Molina Healthcare (Albany, NY)
- …At least 2 years clinical nursing experience, including at least 1 year of utilization review , medical claims review , long-term services and supports (LTSS), ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with… more