- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews ... payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as required.… more
- Catholic Health Services (Melville, NY)
- …requests for services and coordinates utilization / appeals management review. Assist Utilization and Appeals Manager in setting up communications with ... advisors and facility departments. Develops/validates daily work lists for Utilization and Appeals Manager . Assist with all insurance and regulatory… more
- Molina Healthcare (Albany, NY)
- …Utilization Management, Chief Medical Officer, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training, leadership and mentoring for less ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct...Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… more
- Elevance Health (New York, NY)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... **Behavioral Health Medical Director-Psychiatrist Appeals ** **Location:** This role enables associates to work...Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical… more
- Mount Sinai Health System (New York, NY)
- …as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...+ Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements… more
- Mount Sinai Health System (New York, NY)
- …Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
- Mount Sinai Health System (New York, NY)
- …homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5 years? experience as a ... **Job Description** RN/Case Manager Mount Sinai West FT Days 8a-4p EOW...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
- CUNY (Brooklyn, NY)
- …early intervention student support service process, the resolution of student grievances, appeals , and complaints, and the utilization of the Behavioral ... Manager of Student Advocacy and Accountability (HEA) **POSITION...conduct reports; coordinating the student conduct process, grievances, and appeals . + Oversee the Faculty Student Disciplinary Committee to… more
- Hudson Valley Community College (Troy, NY)
- …to build on decades of successful service to our community. Advancement Operations Manager HV-NTP-8575 2 In order to be considered an applicant for this position ... completion of a background check. Position Summary The Advancement Operations Manager position focuses on optimizing donor database (Raiser's Edge) management in… more
- Crouse Hospital (Syracuse, NY)
- …to day management of the RN Care Managers in the department, including Utilization Management, Discharge Planning and Denials and Appeals functions. + Assessing ... outreach programs. Crouse's Care Coordination team is hiring a Manager who is responsible for providing day to day...acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical, Dental, Vision,… more
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