- City of New York (New York, NY)
- …within the Division of Child Protection (DCP) across each borough and zone. The Case Reviewer utilizes a standardized instrument to assess case practice. ... The duties and responsibilities of the Case Reviewer will include, but will not be limited to:...unaddressed safety and risk related concerns identified during the case review . - Complete a quality control… 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)
- …for (1) one Principal Administrative Associate II to function as a NCA PERT Case Reviewer , who will: - Conduct NCA Supplemental Nutrition Assistance (SNAP) ... customer interaction and determine whether appropriate action was taken. - Review case file information, Paperless Office System (POS) entries and Welfare… more
- City of New York (New York, NY)
- …of Constituent Services (OCS) is seeking three (3) 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)
- …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)
- …for one (1) Principal Administrative Associate II to function as a Quality Control Case Reviewers, who will: - Review POS, HRA One Viewer of imaged/scanned ... to ensure that data collected is complete, accurate and appropriate to the case under review . - Prepare manual budgets to replicate the actual amounts issued to… 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
- Guthrie (Binghamton, NY)
- …Management (Days) Full Time Position Summary: The Utilization Management (UM) Reviewer , in collaboration with other internal and external offices, payors, and ... authorization/certification for reimbursement of patient care services. The Utilization Reviewer : * Secures authorization as appropriate * Documents payer… more
- MetLife (Oriskany, NY)
- …inquiries. Perform follow-up activity (send a letter, return a call, refer a case ) as applicable. Review claims submission for completeness and accuracy. Records ... access information required to handle customer inquiries; identify OFEGLI case owners; enter comments into comment window; and complete...as applicable. * Build new claims as well as review and process noncomplex claims (such as single or… 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)
- …with latitude for independent judgment, the Clerical Associate III, functioning as Case Review Specialist, is responsible for reviewing reports to correct ... and reconcile the data integrity of electronic case files. The Case Review Specialist researches and enters data into OCSS's child support system ensuring… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …Workers' Compensation and other Casualty clients. The Workers' Compensation Nurse Case Reviewer collaborates with medical care providers, employers, employees, ... About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review /Medical and Case Management services for Group Health and… more
- New Directions Youth and Family Services (Weston Mills, NY)
- …a leadership and workforce that is reflective of the communities we serve. PERMANENCY CASE MANAGER - Full Time position available (Monday - Friday/35 hours per week) ... based on education and years of relevant experience POSITION SUMMARY: Provides case management services with a focus on permanency to include individual, family,… 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
- Mount Sinai Health System (New York, NY)
- …Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... limited to: + Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED patients ... specified timeframes. * Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using… more
- Mount Sinai Health System (New York, NY)
- …**Responsibilities** 1. Attends interdisciplinary rounds on units as warranted. 2. Meets with Case Managers, as warranted, to review medically complex and long ... to appropriate length of stay. 7. Collaborates with the Director of Case Management to maintain, review and update all Case Management specialty policies in… more
- City of New York (New York, NY)
- … case reopens which have been closed regardless of date; and one-shot deals. - Review specific case and authorizes benefits as required. - Review the ... Associate Benefits Opportunity Specialist II, to function as a Case Management Team Leader, who will: - Monitor the...prepare regular reports on unit activities. - Perform final review of packets prior to fair hearing and determines… more