- University of Rochester (Rochester, NY)
- …Identifies problems that include but are not limited to pre-certifications, Utilization Management, Medicaid Pending, third party payer issues, and denials/appeal ... and follow-up with assigned area, Financial Assistance, Social Work, Utilization Management, Medicaid Enrollment & Outreach, patients, families, third-party payers,… more
- 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
- Rochester Regional Health (Rochester, NY)
- …as soon as possible after admission-within the first12 to 24 hours. Applies utilization review criteria to assess and document appropriateness of admission, ... coordination/patient navigation for patients, including triage management, algorithm management, utilization management and resource management. Organizes services across the… more
- Highmark Health (Buffalo, NY)
- …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses ... verifying benefit coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review , status… more
- Highmark Health (Buffalo, NY)
- …Description :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent assesses ... for the member, and then creates the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review . Ensures all accurate… more
- Highmark Health (Albany, NY)
- …business relationships, the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The role involves ... units that may assist in the resolution of issues or problems. + Access, review , utilize, contribute content to and participate in the maintenance of the shared… more
- WMCHealth (Valhalla, NY)
- …and logistics framework. Responsibilities: . Leads the development, implementation and review of an optimal inventory strategy to ensure the appropriate balance ... of service, quality cost and access are maintained. . Manages the effective utilization of existing warehousing and inventory facilities across the network . Drives… more
- WMCHealth (Valhalla, NY)
- …and logistics framework. Responsibilities: + Leads the development, implementation and review of an optimal inventory strategy to ensure the appropriate balance ... of service, quality cost and access are maintained. + Manages the effective utilization of existing warehousing and inventory facilities across the network + Drives… more
- City of New York (New York, NY)
- …maintain records of proposed and current Agency's Requirement Contracts. Ensure the utilization of these contracts by Procurement Liaisons. Review specifications ... Compliance and Opportunities, Purchasing Management, Accounts Payable Unit, Contracts Review and Negotiations, and the Process Optimization & Change Management… more
- City of New York (New York, NY)
- …maintain records of proposed and current Agency's Requirement Contracts. Ensure the utilization of these contracts by Procurement Liaisons. Review specifications ... Compliance and Opportunities, Purchasing Management, Accounts Payable Unit, Contracts Review and Negotiations, and the Process Optimization & Change Management… more
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