Utilization Review Jobs in Bronx
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Search Results - Utilization Review Jobs in Bronx
NYC Health + Hospitals-Bronx
Provides guidance to health care settings for establishment and maintenance of utilization review, quality assurance and discharge planning programs, which comply with state, federal and The Joint Commission requirements and counsels to resolve operational...
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Bronx
of all billable and non-billable peer support activities in the electronic health record
• Ensure all documentation complies with HIPAA, OASAS Article 32 regulations, and Medicaid billing requirements
• Participate in utilization review, peer review...
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icims.com -
NavitasPartners-Bronx
59 per hour
Position Summary:
The Care Manager RN is responsible for coordinating patient care across the continuum, with a strong focus on utilization review, discharge planning, and care coordination...
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talentnest.com -
Bronx
policies/procedures, VNS Health standards and regulatory requirements.
• Participates and consults with team supervisor in case conferences, staff meetings, utilization review and discharge planning meetings to determine if client/member requires...
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vnshealth.org -
Prodware Solutions LLC-Elmhurst (NY), 9 mi from Bronx
Outpatient and Inpatient computerized systems to enter and access patient care information.
12. Coordinates and analyzes statistics and/or clinical data.
13. Participates in quality management and utilization review programs.
14. May coordinate the work...
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Prodware Solutions LLC-Elmhurst (NY), 9 mi from Bronx
and Inpatient computerized systems to enter and access patient care information.
12. Coordinates and analyzes statistics and/or clinical data.
13. Participates in quality management and utilization review programs.
14. May coordinate the work of a small...
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Pride Health-New York, 12 mi from Bronx
execution, especially with reporting actionable activity by / for clinicians.
• Experience in managed care setting with knowledge of VBP, utilization review, case Mngmt, etc.
• Proficiency in claims analysis.
• Proficiency in SQL (required), SAS (desired...
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Medix™-Jericho (NY), 19 mi from Bronx
of activities related to Utilization or Quality reviews as assigned. They will utilize their knowledge and expertise of the review program to conduct clinical level review, supporting Medical Review Analysts, and Physician Consultants to ensure an appropriate...
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Pride Health-White Plains (NY), 13 mi from Bronx
planning
• Perform Utilization Review (UR) activities and payer reviews
• Arrange post-discharge care and patient education
• Collaborate with healthcare teams to ensure safe patient transitions
Requirements
• BSN required
• Active NY RN License
• 3...
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Greenlife Healthcare Staffing-New Rochelle, 6 mi from Bronx
Registered Nurse license
• Must have a minimum of 2 years experience performing utilization review, claims adjudication, medical review, fraud investigation, surveillance, or monitoring activities; OR
• 3 years of clinical or administrative experience...
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workable.com -
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