Supervisor, Concurrent Review - New York - MJHS

· Overview · The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. The ...

We are seeking a Supervisor to lead our team in New York. The ideal candidate will have experience in managed care and utilization management. Key responsibilities include supervising staff, assessing member care needs, and ensuring compliance with regulations. · Provides quality ...

+ Supervise quality cost effective care to all members + Provides direct supervision of staff responsible for member care + Ensure appropriate staffing supports departmental agency services · ResponsibilitiesDirectly supervise staff responsible for managing coordinating member c ...

+ Provides quality cost-effective care to all members through direct supervision of staff responsible for management coordination of member's care incorporating interdisciplinary strategies medicare regulations medically accepted standards of care + Supervises assessment acute su ...

Job Title: Vice President of Medical Directors · A leading healthcare organization in New York is seeking an experienced medical professional to join its team as Vice President of Medical Directors. This role involves ensuring appropriate health care utilization management. · Rev ...

Golang Developer needed to build scalable backend systems and cloud-native apps. · Golang Developer with experience in building high-performance backend systems and cloud-native apps. · ...

Job Title: Travel Nurse RN - Care Manager · Health Saviours is seeking a travel nurse RN care manager for a variable shift position in York, Maine. · Job Description: · Specialty: Care Manager · Discipline: Registered Nurse (RN) · The successful candidate will coordinate concurre ...

+GoLang Api Developer · Dice is the leading career destination for tech experts at every stage of their careers. · Our client, Digitive LLC, is seeking a GoLang Api Developer Hybrid - New York, NY or Duluth, GA · +Collaborate with Stake holders and relevant teams to design develo ...

We are looking for a GoLang API Developer who can build scalable high-performance backend systems cloud-native apps and microservices. · Collaborate with Stake holders to design develop and maintain. · Optimized Go code designing system architecture code reviews troubleshooting d ...

+Dice es la plataforma líder para encontrar empleos tecnológicos en diferentes etapas de carrera. · ...

A Manhattan-based healthcare organization seeks an experienced Medical Director to assist in ensuring appropriate health care utilization management. · ...

+As a Senior C Engineer, you will work remotely on an hourly paid basis to review AI-generated C code... · +Create detailed prompts in various topics and responses to guide AI learning. · Evaluate and rank AI responses to enhance the model's accuracy, fluency, and contextual rele ...

We are seeking a seasoned Interior Design Director to lead our high-end residential FF&E team. · The ideal candidate brings 7–10 years of leadership experience in high-end residential design. · Maintain design integrity across all phases of work. · ...

Summary Of Position · Support the department's quality of care and cost containment. Provide utilization management as needed to ensure coordination of health care delivery. Conduct medical appropriateness evaluations of acute care hospital admissions, post-acute care requests, a ...

This position will perform administrative support functions for the MNR Medical Assessment Center. This includes assisting nursing and medical staff, processing employees, preparing correspondence and reports, training Health Services Assistants (HSAs), and reviewing their work. ...

The Director of Utilization Management is a strategic clinical operations leader responsible for delivering operational oversight for Utilization Management (UM) teams. · ...

The Utilization Review Nurse processes prospective concurrent retrospective UM medical requests while ensuring compliance with SPD time frames clinical policies operational workflows. · Process prospective concurrent retrospective UM medical requests · Maintain monitor review the ...

We are seeking an experienced Go Engineer for AI Data Training who will review AI-generated code and provide expert feedback. · ...

Description · 3034464: Utilization Insurance Specialist -Psychiatry Child Inpatient Unit -MSM- Full Time Day · Job Summary:  · To provide clinical information to Managed Care/Insurance Companies/BHO to demonstrate medical necessity and ensure reimbursement. · Responsibilities · R ...

Develop analytics engineering abstraction, create reusable data assets for DS/AI/ML models and work with BI and Compliance teams to define and implement requirements for key regulatory and financial reporting. · ...