Utilization review jobs in Elmhurst, NYCreate job alerts

Continually adapt warehouse layout to ensure efficient space utilization of Facilities/Building Maintenance * Review and approve all Operational Invoices for payment * Learn and continually re ...

Responsibilities: Preparation: • Review Electronic Medical Records (EMR) and previous assessments to prepare for visits. • Utilize critical thinking and problem-solving skills for case ...

Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using standardized criteria to achieve optimal patient outcomes and ...

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

Develop, implement and evaluate case management programs, including utilization review, and discharge planning. * Establish and maintain relationships with community-based services and organizations ...

A minimum of two years experience performing utilization review, claims adjudication, medical review, fraud investigation, surveillance or monitoring activities, required; OR * Three years of ...

... review, etc., following established MetroPlusHealth Utilization Management policies, procedures, and protocols. - Oversee the coordination and delivery of comprehensive, quality healthcare and ...

... on proper utilization of those medical devices. * Supervise procedures for students taking ... Review and maintain accurate and current health records in accordance with local governmental ...

Minimum Qualifications NYC Children's Center is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and efficiency of psychiatric and medical services ...

Assess appropriate site of care utilization and continued medical necessity reviews for prior authorization to vendors. * Ensure communication with MD offices in relation to Site of Care program

... to ensure optimal utilization of services. * Ensure quality standards set by the external ... Provide ongoing review of emergency equipment, biological and medications in order to maintain ...

Utilize evidence-based strategies to prevent hospitalization and inappropriate ER utilization ... Review and authorize service requests according to workflows and timelines. * Collaborate with ...

... utilization, billability, grade pyramids etc. * Experience in planning, organizing and tracking Digital Trainings * Experience in creating management review reports. * Experience in Advance MS Excel

The position also involves reviewing outcomes, coding, and utilization data to enhance participant health and reduce unnecessary utilization. Benefits * Medical, Vision, Dental, and Life Insurance

... Review, engage, plan and deploy necessary security governance process' and practices so that ... utilization of Cybersecurity resources, · Drive strategy for security awareness management · ...

Directs review of adjustments, credits and payments to patients' accounts. 5.Directs periodic ... Prepares status reports, analyses and recommendations to obtain optimum utilization of total ...

... and utilization of referral services, as part of the health care system. Assists in providing ... Reviews and analyzes trends pertinent to delivery of nursing care services and collaborates with ...

Review and interpret screening and diagnostic observations and report findings to the project ... Familiarity with database utilization, regulatory compliance and human subject's protection issues

Review Patient medical documentation * Setup communication to assist patient enrollment into managed care plans * Performs other duties that may be assigned Qualifications: * New or Previous ...

Job Summary: • 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 ...

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 current work and make regular reports to senior management about how InRhythm teams and ... Optimize utilization and resource planning across the organization by making staffing decisi

Applications will be reviewed on a rolling basis until the position is filled. The mission of the ... Optimize resource allocation and utilization to ensure efficient and effective product operations

Review and update medication list to ensure accurate and complete list in electronic medical record (EMR) available for provider review and submission. Complete referrals and tracks patients ...