Utilization Review Specialist jobs in Jamaica, NY

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Clinical Documentation Specialist - 00165-7423 (Clinical Doc...
JFK Medical - 204 reviews - Edison, NJ
The individual will perform concurrent inpatient medical record reviews. The Clinical Documentation Specialist (CDS) facilitates improvement in the overall...
Field Access Specialist - Queens, NY
Regeneron - 82 reviews - Queens, NY
Prior Authorization Processes, Step Edits, Appeals, detailed Clinical Documentation, Peer to Peer reviews etc. requires dedicated and focused customer facing...
MICA Specialist
Brooklyn Community Housing & Services, Inc. - Brooklyn, NY 11205
$40,000 a year
Participate in Utilization Reviews, Incident Reviews. Document Medicaid Billable Notes and submit for review in a timely manner....
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Specialist, Long Term Care Utilization Management - Telecomm...

Healthfirst - 657 reviews - New York, NY
The LTC Utilization Management Specialist supports primary care managers by arranging qualified services for their members....

Clinical Process Specialist | RN or LPN | Brooklyn

AccentCare - 180 reviews - New York, NY
Knowledge of Quality Improvement, Utilization Review and Risk Management. Clinical Process Specialist. As a Clinical Process Specialist you will:....

Care Specialist - 4405-208-N

CCBQ - Queens, NY
Reassesses needs for Health Home services and reviews health home members’ historical or targeted clinical measurements (i.e....
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Clinical Nurse Specialist, RN Consultant (Mental Health)

Sheltering Arms Children and Family Services, Inc. - 13 reviews - Far Rockaway, NY 11691
Assist with the review and preparation of case record reviews and audits, i.e. PSYCKES. Attend 1 to 2 monthly supervisory sessions to ensure communication...

MICA Specialist

Brooklyn Community Housing & Services, Inc. - Brooklyn, NY 11205 (Fort Green area)
$40,000 a year
Participate in Utilization Reviews, Incident Reviews. Document Medicaid Billable Notes and submit for review in a timely manner....
Easily apply

MLTC Clinical Quality Improvement Specialist

MetroPlus Health Plan - 64 reviews - New York, NY
$90,000 a year
Experience in medical records review, utilization and case management in a clinical practice or managed care organization....

Specialist / 1H

ConEdison - 4 reviews - New York, NY
Vendor management experience including ongoing vendor interaction, review of program utilization, oversight of performance guarantees and program effectiveness....

Field Access Specialist - Queens, NY

Regeneron - 82 reviews - Queens, NY
Prior Authorization Processes, Step Edits, Appeals, detailed Clinical Documentation, Peer to Peer reviews etc. requires dedicated and focused customer facing...

Health Services Specialist

Amida Care - 22 reviews - New York, NY
Knowledge of Article 49- Utilization Review process. Collaborate with hospital and UM staff to request clinical information required for utilization review....

Managed Care/Payor Relations Specialist

Memorial Sloan Kettering - 495 reviews - New York, NY
As the Manager Care/Payor Relations Specialist, you will:. Assist in managed care contract language review for existing and new managed care contracts....
DRG Reviewer
MJ Morgan Group - 10 reviews - New York, NY
Inform the personnel involved in the review process of any applicable coding guidelines, conventions and information that will ensure quality in DRG reviews....
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Documentation Specialist
Provides post discharge/pre-bill retrospective review of records in HIM for potential documentation improvement by applying concurrent standards of review and...

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