Utilization review jobs in Forest Hills, NYCreate job alerts

Engages in formal and informal peer and institutional review processes * Collaborates with interdisciplinary teams to create and implement quality improvement projects, evidence-based practice ...

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

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 ...

Participate in utilization and peer review programs which evaluates the quality of the medical staff and medical services being performed at the clinics * Provide supervision and consultation to ...

Utilization Management * Participate in utilization review and management. * Maintain focus on key strategic priorities including patient experience, access to care, increased market share, and ...

The Case Manager is responsible for all aspects of discharge planning and utilization management/review for an assigned group of patients to determine the appropriateness of the admission and ...

Participate in Utilization reviews and remaining available for emergency consultations. • Analyze the best medications or therapy treatment to help patient maximize quality of life. * Maintain ...

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 patient charts for missing labs, reports, and/or open orders * Triage urgent same day or double book appointment requests * Coordinate and participate in daily huddles * Assist with inventory ...

... 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 ...

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

Coordinate with Utilization Management (UM) department on concurrent and retrospective review. * Follow up with assigned nurses for clinical updates to care plan. * Document within two business day ...

... 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 ...

Assures proper cost-effective utilization of resources. * Maintains an environment that is conducive to meeting patient care needs and that facilitates patient flow. * Promotes and provides for ...

Reviews stock levels, storage locations and utilization of film inventories and medical and surgical supplies 8.Performs related duties, as required." Job Qualification: Graduate of an accredited ...

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

Coordinate with Utilization Management (UM) department on concurrent and retrospective review. Follow up with assigned nurses for clinical updates to care plan. Document within two business day ...

Conduct Utilization review via Chart Review. * Conduct timely concurrent reviews and responses to third party payors request for clinical reviews. * Work collaboratively with ED Case Managers and ...

This CARM role will manage a team responsible supporting SPGI's acquisition, utilization, and distribution of market data sourced from stock exchanges globally. The primary focus will be to review ...

... Review, Discharge Wrap Up, and MD/RN Unit Collaboration. 2. Considers the patient's values, preferences, cultural diversity, expressed needs and knowledge in all aspects of care. 3. Establishes 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 ...

Assess, review, and maintain that daily resident care needs are met, and appropriate resident care is given * Address resident and staff concerns to promote quality care * Supervise staff nurses and ...

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 ...

Visits each assigned home weekly (minimally) to provide nursing oversight and complete review of items. * Interacts with primary, medical specialists, various clinical staff as necessary. * Advocate ...