- Catholic Health Services (Melville, NY)
- … clinical expertise/reference for specialty services as needed to adequately prepare clinical review and/or appeal. | Demonstrates aptitude and skill in ... Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and...care to MCC in response to physician order, or review of updated clinical information | Acts… more
- Catholic Health Services (Melville, NY)
- …Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical documentation. ... employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health,… more
- VNS Health (Manhattan, NY)
- …management teams to generate timely requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable ... opportunities What You Will Do + Delivers timely notification of clinical decisions that are conditions for discharge. Identifies potential barriers including,… more