- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: This Utilization Review Denials Review Unit (DRU) 3 Team Lead will assist the Director of Utilization Review and the Associate ... Director of Utilization Review with daily staff mentoring, leadership and resource provision....and provides feedback/mentorship to UR CR I as to review , payor and regulatory questions. This UR DRU 3… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Utilization Review Clinical Review (CR) 3 Team Lead will assist the Director of UR and Associate Director of UR with daily staff mentoring, ... one business day and/or time frame per negotiated contract, to prevent payment denials . Participates in interdisciplinary rounds on a regular basis to assist with… more
- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
- Crouse Hospital (Syracuse, NY)
- …related to acute care discharge planning. + Preferred: + Acute care utilization review experience. + Previous leadership experience. + SPECIAL SKILLS/EQUIPMENT ... achievement of optimal health, access to care and appropriate utilization of resources, balanced with the patient's right to...Manager works closely with the UM and Appeals and Denials staff as both areas work in tandem to… more
- Planned Parenthood of Central and Western NY (Syracuse, NY)
- …regulations as well as having a clear understanding of laws impacting utilization management of credentialing for government health plans as well as auditing ... to evaluate Third-Party payer contracts; investigates and resolves medical claim denials related to Enrollment Credentialing, Coding, or other Payer issues to… more