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The primary function of the Clinical Quality Reviewer is to assess and audit medical charts for compliance with a focus on HEDIS, QARR, Medicare Advantage Star measures and quality improvement activities. Quality audit findings from this position will contribute to the support and training of phy...

The Career Services is recruiting for one (1) Clerical Associate III to function as Documentation Reviewers who will:.

The Department of Design & Construction, Division of Public Buildings, Architecture and Engineering Unit seeks a Senior Design Reviewer (Electrical).

Work Location: 30-30 Thomson Avenue, LIC, NY 11101.Candidates must be permanent in the Civil Engineer title, or reachable on the Open-Competitive List (Exam #9045 or #0156) or must have filed for the DDC Promotional Exam #4522, or the Open-Competitive Exam #4030 in March 2024 to apply for this po...

You are welcoming, reassuring, and have a passion for providing exceptional customer service.You are a go-to tax expert with 3+ years filing a minimum of 30 federal and state individual tax returns annually.You are an exceptional communicator and enjoy translating complex tax terminology into a l...

Based on a comprehensive review of the client's overall condition, prepares, continually reviews and evaluates plans of nursing intervention to ensure that such interventions are consistent with the ...

Reviews and analyzes trends pertinent to delivery of nursing care services and collaborates with Director of Nursing for innovation. * Participates in interdepartmental and interdisciplinary meeting ...

Review incoming referrals and update medical chart + medical tracking * Schedule medical appointments * Complete, quarterlies, semi annuals and annual CFAs * Review and update individualized plan of ...

Review of required medical tests and documents pertaining to consultations and medical histories * Secure a thorough health history from the applicant and record findings * Arrange (but not ...

Conducts reviews and provides expertise on highly complex operative reports and medical records for the Pre-Payment review process. * Performs ongoing and in depth CPC training to Special ...

Reviews complaints and grievances made or filed by staff. Makes appropriate reports to the Nursing Manager/charge nurse as required or as may be necessary. * Ensures that staff participates in and ...

Review and evaluate the assessment and UAS information for members in the MLTC and MAP lines of business. Develop a working relationship with the PCP to be able to contact and discuss the care of the ...

This plan should be reviewed and revised as needed. * Integrates therapeutic intervention techniques into programs or home of person served through consultation with parent/guardian and staff at team ...

Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations * Reviews referrals information and intake assessments to ...

Yearly review for growth opportunities * Professional Development Growth Tracks * Tuition discounts for employees and their families * TicketsAtWork and LifeMart company perks * Our workplace fosters ...

The Medical Director will provide ongoing development and review of protocols to ensure optimized care for patients is in compliance with licensing agencies. Participates in agency-wide QA Committee ...

Review and evaluate the assessment and UAS information for members in the MLTC and MAP lines of business. * Develop a working relationship with the PCP to be able to contact and discuss the care of ...

RN Nurse Assessor - Hybrid JOB SUMMARY Ability to review health status questions and make evaluations and determinations based on UAS criteria for enrollment; ability to work with technology in the ...

Risk Review Team: * Attend bi-weekly (every 2 weeks) 1 hour team meetings to review higher risk cases and make recommendations. Receiving Supervision/Training: * Attend weekly 1 hour group ...

Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift and mid shift Job types available: full time, part time, and per diem Employer features: Cross training ...

Must submit Resume, Nursys Verification, NY License # and BLS (If not, BLS is required before the start date) JOB SUMMARY Ability to review health status questions and make evaluations and ...

Assists in reviewing and revising policies and procedures. * May be responsible for the precertification and preauthorization of prescriptions. * When needed, records medical information within the ...

For additional information on the Center please review our website: Educational Opportunity Centers (EOC) provide academic instruction, vocational training, and support to educationally and ...

Must have a minimum of 2 years experience performing utilization review, claims adjudication, medical review, fraud investigation, surveillance, or monitoring activities; OR * 3 years of clinical or ...