- Independent Health (Buffalo, NY)
- …benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Clinical Reviewer will be responsible for the collection and review ... support of a high performing health plan and physician network. The Clinical Reviewer will investigate quality complaints/grievances and appeals, document… more
- City of New York (New York, NY)
- …variety of health-related topics. The office also conducts research and provides clinical expertise in developing health and mental health policies that support best ... in foster care. The New Admissions Focused (NAF) Nurse Reviewer will be responsible for: 1. Scheduling and conducting...5 boroughs 2. Participating in all post medical record review quality monitoring and corrective action processes 3. Conducting… more
- MVP Health Care (Tarrytown, NY)
- …improvement. To achieve this, we're looking for a **Professional, Sub-Acute RN UM Reviewer - Medicare** to join #TeamMVP. If you have a passion for patient-centered ... advocacy, clinical precision and regulatory compliance this is an opportunity...ensure optimal patient care and resource utilization. + Document review outcomes and maintain compliance with regulatory and organizational… more
- Nuvance Health (Poughkeepsie, NY)
- …via program dashboard on quality and process measures.Participates in quarterly Utilization Review . 7.Prepares reports to DQS and Clinical Team as appropriate. ... Must be available during weekday hours. 8a-5p *Purpose: *The Quality Systems Reviewer assists in the implementation of the Agencyi? 1/2s Performance Improvement,… more
- Mount Sinai Health System (New York, NY)
- …Monitoring System. The PM is responsible for all ensuring that all cancer-related clinical research receives appropriate peer- review prior to activation and then ... the IRB, Clinical Research Support Unit (CRSU), and Financial Feasibility Review (FFR) and Community Outreach and Engagement (COE) to align processes, reduce… more
- Centene Corporation (New York, NY)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... and cost effectiveness of medical care. + Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in… more
- CDPHP (Latham, NY)
- …to take prior to logging and routing requests for authorization to the appropriate clinical reviewer . CSS reviews clinical documentation and determines at ... you to be a part of that experience. The clinical support specialist (CSS) provides administrative support to ...and work in multiple systems required. + Ability to review documents and use critical thinking. + Strong attention… more
- Catholic Health (Buffalo, NY)
- …for the patients of Catholic Health. The QPS Nurse Reviewer and Clinical Specialist is also responsible for chart review for the following indicators: ... Days Hours: Summary: The Quality & Patient Safety (QPS) Nurse Reviewer and Clinical Specialist is the primary site individual responsible to identify quality… more
- HCR Home Care (Rochester, NY)
- …educational needs. + Clinical assistance : + Triage incoming calls. + Audit/ Review DRRs . + Other duties as assigned. This job description reflects management's ... - $48.08 Hourly Role and Responsibilities The Afterhours/ Weekend Clinical Field Staff Supervisor (CFSS) is an integral part...or advising on patient care questions or concerns. + Review and approve all new interim orders before they… more
- Pfizer (New York, NY)
- …results + Support execution for all FIH programs through proof-of concept + Set the clinical data review strategy, ensure quality data and conduct review of ... emerging clinical data and trends; review and query data; present and discuss relevant data...and other internal and external stakeholders + Conduct data review , analysis and interpretation of clinical trials… more
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