- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **The Utilization Review Physician collaborates with the healthcare team in the** **management and resolution of activities that assure the ... population and Hackensack UMC. These include but are not limited to utilization review ,** **hospital reimbursement, clinical compliance, case management, and… more
- Mount Sinai Health System (New York, NY)
- …Admission Specialist (OR Scheduler), Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The Utilization Review Specialist coordinates ... testing and operating roaom time. 7. Checks credentials system for physician 's delineation of privileges for equipment and/or procedures according to medical… more
- Hackensack Meridian Health (Hackensack, NJ)
- …**Hackensack Meridian** **_Health_** includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team...appropriate records as required by payer agencies and initiates physician advisor's review as necessary for unwarranted… more
- WMCHealth (Valhalla, NY)
- …management areas of Integrated Case Management including mentoring/coaching care coordinators, utilization review staff and social workers. + Reviews cases ... objectives. This position plays an important role in ensuring physician support and execution of for Utilization ... guidelines and parameters to assure consistency in the review process to reflect appropriate utilization and… more
- BronxCare Health System (Bronx, NY)
- …prepare a response for submission in appeal. - In absence of Director, will review denial correspondence to determine validity of denial reason and course of action ... as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate with ECFMG certification preferred .… more
- WMCHealth (Valhalla, NY)
- …and coding principles and guidelines; good knowledge of healthcare delivery system, utilization review , case review and quality improvement practice ... approach and plan for physician responses to queries, including physician escalation assistance Full Performance Knowledge, Skills, Abilities and Attributes:… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Hackensack University Medical Center Night Shift RRT Nurse Practitioner or Physician Assistant performs the role utilizing the patient-centered coordinated care ... of specialty practice. 5. Participates in APRN interviewing, credentialing, and peer review process as requested. 6. Participates in a minimum of one professional… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **The Surgical Nurse Practitioner or Physician Assistant at Hackensack UMC performs the role utilizing the patient-centered coordinated care model ... of specialty practice. 5. Participates in APRN interviewing, credentialing, and peer review process as requested. 6. Participates in a minimum of one professional… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Neurocritical Care Advanced Practice Nurse or Physician Assistant performs the role utilizing the patient-centered coordinated care model ... of specialty practice. 5. Participates in APRN interviewing, credentialing, and peer review process as requested. 6. Participates in a minimum of one professional… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **The Inpatient Consultation Liason Nurse Practitioner or Physician Assistant performs the role utilizing the patient-centered coordinated care model ... of specialty practice.** **5. Participates in APRN interviewing, credentialing, and peer review process as requested.** **6. Participates in a minimum of one… more
- Mount Sinai Health System (Queens, NY)
- …for appropriate utilization of resources used in those cases, referring physician communication and timely review and signing of reports. + Participating ... affiliation with New York City Health + Hospitals/Elmhurst is seeking a full -time Breast Radiologist. Elmhurst Hospital Center is a 545-bed tertiary care facility… more
- Mount Sinai Health System (New York, NY)
- …Practitioner-Critical Care Physician Extenders- Mount Sinai Hospital- Split Shift- Full Time** A nurse practitioner (NP) as described in Title VIII, Article ... the plan of care. + Performs a patient record review with the collaborating physician in a...Ability to interpret and apply principles of nursing research utilization . + Ability to manage and coordinate a patient… more
- Mount Sinai Health System (New York, NY)
- …Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager ... are not limited to: a. 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)
- …Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... are not limited to: 1. 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)
- …interprets the clients responses to the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion but not less than ... to established standards as part of initial orientation and annual performance review with collaborating physician or appropriately credentialed designee. 4.… more
- Nuvance Health (Danbury, CT)
- …for providing strategic leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff ... *System Care Coordination Leader* will be responsible for leading a team encompassing utilization review and denials/appeals specialists and will need to foster… more
- Mount Sinai Health System (New York, NY)
- …interprets the client's responses to the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion but not less ... to established standards as part of initial orientation and annual performance review with collaborating physician or appropriately credentialed designee. 4.… more
- Mount Sinai Health System (New York, NY)
- …The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse, Physician Assistant, or Nurse Practitioner, who manages the 24 hour a day ... patient-centered care. **Qualifications** * Must be a Licensed Registered Nurse, Physician Assistant or Nurse Practitioner Registered Nurse Bachelor's Degree in… more
- Mount Sinai Health System (New York, NY)
- …to influence other services by focusing on patient processes. 10.Develops and implements Utilization Review (UR) based on internal data collection, data received ... the delivery of comprehensive front-line Case Management services, including utilization management, care facilitation and discharge planning. The Director works… more
- Hackensack Meridian Health (Hackensack, NJ)
- …ED inpatient admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance ... worksheet and computer system as appropriate. + Extensively reviews all physician and clinical documentation, lab results, diagnostic information and treatment plans… more