- VNS Health (Manhattan, NY)
- …and follow-up with appropriate service providers and managed care plans. Facilitates periodic case record reviews and case conferences with all providers serving ... necessary to maintain and enhance care management skills.Maintains updated case records in program EMR. Maintains case ...the end of Phase 3 for each patient to review patient's progress toward goals and determine whether additional… more
- Pailin Group Psc (New York, NY)
- …by coordinating patient scheduling to compensate for no-show rate. Responsible for chart review and peer review following the guidelines established by the ... Policies and Procedures Committee. Must review 5 charts per week per clinic. Responsible for...providers and signs their charts as assigned.Attends all clinic case conferences to discuss difficult patients.Works with nursing and… more
- Desort (Hoboken, NJ)
- … strategies and trial preparation.Manage discovery processes, document review , production, and deposition preparation.Maintain effective communication with clients, ... colleagues, and third parties.QualificationsJuris Doctor (JD) degree from an accredited law school.Admission to the New Jersey State Bar with 4-5 years of litigation experience.Strong background in commercial litigation and product liability matters.Excellent… more
- VNS Health (Bronx, NY)
- …with State / Federal regulations and Agency policies.Initiates / participates in case conferences of difficult to service clients & represents program on record ... review and quality assurance review committees.Performs all inherent duties in a supervisory role. Ensures effective staff orientation & training, interviews… more
- The Vitamin Shoppe (Secaucus, NJ)
- …of outside counsel.ResponsibilitiesServe as the Company's Compliance Officer: Monitor case law, regulatory matters, proposed legislation, and other developments ... mergers, acquisitions, and joint ventures. Provide legal advice concerning the review and negotiation of contracts, leases, and other legal instruments.Oversee legal… more
- Genmab (Perth Amboy, NJ)
- …standards, GVP); MedDRA and WHODrug coding dictionaries; and individual adverse event case report processing, triage and medical review . Experience with ... Drug Safety staff in managing the safety assessment of products, including review of individual and aggregate AEs and the scientific literature, preparing safety… more
- Lee, Nolan & Koroghlian, LLC (Saddle Brook, NJ)
- …have a deep knowledge of quality of advice standards and the ability to review and/or create plans. Will Leverage internal and external resources, and partner with ... Regional Directors, Internals, and the Case Consulting Unit. Have the ability to identify where a planner is at in their growth and knowledge; and create awareness… more
- City of New York (New York, NY)
- …The Office of Constituent Services (OCS) is seeking (1) Eligibility Specialist II to function as Case Reviewer . The Case Reviewer will: - Respond to ... (NAMI-Net Available Monthly Income) if institutionalized. - Interview and/or review documentation submitted by applicants/recipients (A/R) or authorized representatives,… more
- City of New York (New York, NY)
- …for (1) one Principal Administrative Associate II to function as a Quality Control Case Reviewer , who will: - Conduct the preliminary monthly review ... the review sample by conducting preliminary WMS inquiries and case review ; utilize reports to verify that sample is auditable; identifies inconsistencies,… more
- City of New York (New York, NY)
- …the final report. CA PERT Sr. Reviewer prepares lawsuit packets for each case in the review for electronic transmission to NYC Corporation Counsel. - Conduct ... during customer interaction, and determine whether appropriate action was taken. - Review case file information, POS entries and WMS data to report on the… more
- City of New York (New York, NY)
- …Office of Constituent Services (OCS) is seeking (2) Eligibility Specialist II's to function as Case Reviewers. The Case Reviewer will: - Respond to inbound ... (NAMI-Net Available Monthly Income) if institutionalized. - Interview and/or review documentation submitted by applicants/recipients (A/R) or authorized representatives,… more
- City of New York (New York, NY)
- …is recruiting for (1) one Supervisor of Nurses to function as a Complex Medical Case Reviewer , who will: - Conduct medical reviews and analyses claims to ... calculate injury related Medicaid liens pursuant to SSL-104b on cases involving Medical malpractice, mass medical torts, lead paint poisoning, traumatic brain injury, or other catastrophic or medically complex cases. - Consult Medicaid payment records, bills… more
- City of New York (New York, NY)
- …legal and federal, state and city regulatory requirements. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... Assurance & Fiscal Integrity (OQA&FI) / The Process Evaluation Review Team (PERT) is recruiting for (2) one Principal...one Principal Administrative Associates III, to function as Senior Case Reviewers who will: - Conduct legally mandated … more
- City of New York (New York, NY)
- …information to ensure that data collected is complete, accurate and appropriate to the case under review . - Prepare manual budgets to replicate the actual ... Administrative Associate II to function as a Quality Control Case Reviewers, who will: - Be responsible for the...information in order to determine if discrepancies exist. - Review POS, HRA One Viewer of imaged/scanned documents, Welfare… more
- City of New York (New York, NY)
- …THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... for (2) two Principal Administrative Associates IIIs, who will function as Senior Case Reviewers: - Conduct legally mandated case reviews to comply with… more
- City of New York (New York, NY)
- …medical and mental health policies, programs, and initiatives that support best case practice agency wide. The Medical Review Authorization and Monitoring ... the health care provided is comprehensive and appropriate. OCFH also offers individualized case consultations and training to ACS staff and foster care agencies on a… more
- Centers Plan for Healthy Living (Queens, NY)
- Physical Therapy Reviewer Jamaica, Queens, NY, USA Req #1050 Monday, August 5, 2024 Centers Plan for Healthy Living's goal is to create the ultimate healthcare ... their home to improve their quality of life. The Utilization Management Reviewer will assess and process Therapy authorization requests to determine medical… more
- City of New York (New York, NY)
- …for one (1) Principal Administrative Associate III to function as a Quality Control Case Review Supervisor who will: - Supervise and provide guidance to Quality ... the Enhanced Quality Assurance System (EQAS) or the State Case Review units. Provide guidance and clarification...are in compliance with the State. - Train QC Case Reviewer on these rules and procedures… more
- City of New York (New York, NY)
- … case determinations and take action to resolve outstanding issues. - Review case inquiries submitted by community-based organizations and conducts research ... general supervision of the Case Resolution Supervisor, the Case Resolution Specialists review and resolve case inquiries submitted by partner… more
- The Mount Sinai Health System (New York, NY)
- …limited to: + Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using ... Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5… more
