- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews ... for additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as required. +… more
- Catholic Health Services (Melville, NY)
- …for services and coordinates utilization / appeals management review. + Assist Utilization and Appeals Manager in setting up communications with payors ... advisors and facility departments. + Develops/validates daily work lists for Utilization and Appeals Manager . + Assist with all insurance and regulatory… more
- Mount Sinai Health System (New York, NY)
- …as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...+ Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements… 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. ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
- CUNY (Brooklyn, NY)
- …early intervention student support service process, the resolution of student grievances, appeals , and complaints, and the utilization of the Behavioral ... Manager of Student Advocacy and Accountability (HEA) **POSITION...conduct reports; coordinating the student conduct process, grievances, and appeals . + Oversee the Faculty Student Disciplinary Committee to… more
- Elevance Health (New Hyde Park, NY)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... ** Manager , Medical Director - Transformation Initiatives** Location: This...of Care / Payment Integrity** + **Care Management / Utilization Management (CM/UM) Modernization** + **Provider Networking & Modernization**… more
- Amgen (New York, NY)
- …us and transform the lives of patients while transforming your career. **Field Reimbursement Manager - New York Metro** **What you will do** Let's do this. Let's ... change the world. In this vital role the Field Reimbursement Manager (FRM) will manage defined accounts within a specified geographic region for Patient Access and… more
- City of New York (New York, NY)
- …hearings by mail, web, and mobile app. In addition, the judges hear appeals of parking ticket determinations, and a special unit for Commercial Adjudications ... conducts hearings and appeals on tickets issued to commercial vehicles. The Customer...Analyst (Non-Managerial Level 2) to serve as the Operations Manager for the STARS Modernization Project. The selected candidate… more
- Elevance Health (New York, NY)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... not required for posting. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical program and/or independently… more
- Elevance Health (New York, NY)
- …Director** **Carelon Medical Benefits Management** **Post Acute Care Benefit Utilization Management** **Schedule: 10:00-7:00 Central Time** **** **Virtual:** This ... for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures consistent use of medical… more
- Elevance Health (New York, NY)
- …for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures consistent use of company ... Coverage Determinations, as applicable. + Perform physician-level case review of utilization requests for procedures and interventions listed above. + Conduct… more