- 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 ... experience is required. Must possess comprehensive and broad knowledge of complex clinical and medical concepts and demonstrate overall proficiency in clinical … more
- 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....required. Must possess comprehensive and broad knowledge of complex clinical and medical concepts and demonstrate overall proficiency in… more
- Helio Health Inc. (Syracuse, NY)
- …referring to the medical provider those that require additional expertise. + Review clinical information for concurrent reviews, extending the length of ... preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care setting. +… more
- Crouse Hospital (Syracuse, NY)
- …while maintaining the quality of care. + Demonstrates proficiency with standard Utilization Review processes. + Responsible for concurrent and continued stay ... and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage data and client… more
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The RN Utilization Management Nurse Coordinator is responsible for both concurrent and ... retrospective inpatient and outpatient services, in accordance with the utilization requirements and 3rd party payor contracts. The UM...in the UMCC department, gather and renew denial metrics, review and evaluate LOS O/E metrics for trends and… more
- Molina Healthcare (Syracuse, NY)
- …in ICU, Medical, or ER unit with previous experience in Prior Authorizations, Utilization Review / Utilization Management and knowledge of Interqual ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Trinity Health (Syracuse, NY)
- …12-day shifts. Emergency department experience preferred. **Position Purpose:** The Registered Nurse Utilization Review (UR), Clinical Care Manger (CCM) ... actively manages the utilization review process and patient progression from Admission to Discharge....works collaboratively with unit staff and support team (RN, Physician/ Clinical Affiliate, DPA, MSW, CDI, Rehab Services, etc.) to… more
- Guthrie (Cortland, NY)
- Position Summary: This is an integrated Case Management and Utilization Review position. The Acute Care Case Manager utilizes industry accepted processes for ... years of experience in an acute care setting with strong case management, utilization review and payer knowledge. Case Management certification is encouraged… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Utilization Review /Quality Assurance Sr. Coordinator will be responsible for providing clinical information to managed care companies as ... agencies, and other health care related entities. Preferred Qualifications: Utilization Review /Managed Care/Quality Assurance experience. Experience in the… 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...+ Working knowledge of MS Office. Expert knowledge of clinical review criteria such as InterQual, Milliman… more
- Crouse Hospital (Syracuse, NY)
- …programs. Crouse's Care Coordination Services team is hiring a Care Manager to review the services delivered to patients and compare to evidence-based guidelines in ... maintaining the quality of care. + Participates in the utilization management process using standards of care to determine...assessment of the patient's discharge plan based on the clinical course and proactively interacts with the healthcare team… 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 ... under their respective delegated credentialing agreements. + Works collaboratively with Clinical Services and Human Resources to develop and implement seamless… more
- Guthrie (Cortland, NY)
- …and off-duty/shift and will utilize best judgement during calls for service as to the utilization of the K9 paying close attention to all things that may affect, or ... and maintains complete, and comprehensive reports and logs relating to training, utilization , care, feeding, deployment and inflicted injuries of the K9. Officer: *… more
- SUNY Upstate Medical University (Syracuse, NY)
- …reports. Schedules patients, and keeps attendance and therapy records. Interfaces with utilization review social services, discharge planner, and therapy team to ... departmental activities. Functions under the general supervision of a coordinator/ Clinical Director. Minimum Qualifications: Bachelor's degree in Recreational Therapy… more
- SUNY Upstate Medical University (Syracuse, NY)
- …accurate attendance and therapy records. Interfaces with nursing, medical staff, utilization review social services, discharge planner, therapy team to ... other departmental activities. Functions under general supervision of a coordinator/ Clinical Director. Minimum Qualifications: Masters Degree in Art Therapy.… more
- Trinity Health (Syracuse, NY)
- …communities. Vision: .To be world-renowned for passionate patient care and outstanding clinical outcomes. Core Values: .In the spirit of good _Stewardship,_ we heal ... . Completes and properly submits performance appraisals by established review date. . Demonstrates evidence of utilizing appropriate disciplinary action(s)… more