- 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, ... The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review /Medical and Case Management services for Group...the evaluation of coverage under the Plan. The Nurse Case Reviewer reports to the Casualty Department… 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)
- …for (2) two Principal Administrative Associates 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
- Centers Plan for Healthy Living (Queens, NY)
- Physical Therapy Reviewer Jamaica, Queens, NY, USA Req #1050 Monday, September 9, 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
- The Mount Sinai Health System (New York, NY)
- …Responsibilities:** + Attend interdisciplinary rounds on units as warranted. + Meets with Case Managers, as warranted, to review medically complex and long-stay ... to appropriate length of stay. + Collaborates with the Director of Case Management to maintain, review , and update all Case Management specialty policies in… more
- The 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
- 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
- The 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
- Win (Women In Need) (New York, NY)
- Title of Position: Case Manager Department: Social Services Reports to: Social Service Supervisor FLSA Status: Non-Exempt Salary: $25.22 per hour Positions reporting ... to this position: None Purpose of the Position The Case Manager is responsible for case management services for clients in transitional housing. The Case … more
- Win (Women In Need) (New York, NY)
- Title of Position: Case Manager - WinWest Department: Social Services Reports to: Social Service Supervisor FLSA Status: Non-Exempt Pay Rate: Hourly $27.50 Positions ... reporting to this position: None Purpose of the Position The Case Manager is responsible for case management services for clients in transitional housing. The … more
- City of New York (New York, NY)
- …five (5) Associate Benefits Opportunity Specialist-I's (ABOS-I's) to function as Case Management Supervisor. Under the direction of the Associate Benefits ... and its components (Application, Financial Planning, Employment Planning, Undercare, etc.). The Case Management Supervisor will: - Supervise a team of BOS workers… more