- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… 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...Manager works closely with the UM and Appeals and Denials staff as both areas work in tandem to… 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 ... to evaluate Third-Party payer contracts; investigates and resolves medical claim denials related to Enrollment Credentialing, Coding, or other Payer issues to… more