Latest Utilization Review Physician jobs in New York, NY

16 Utilization Review Physician Jobs in New York, NY

Pharmacy Manager RightPro Staffing - , NY, United States Formulary tool and makes recommendations to the Corporate Director for revisions or enhancement. Monitors and reports Physician prescribing patterns and medication utilization trends. Under the direction 2 days ago
Medical Director -Radiologist - eviCore - Remote Cigna - Remote, New York, USA necessity of services that do not meet utilization review criteria. Review appeals for denied services related to relevant medical experience and our evidence-based guidelines, in accordance with appeal 10 days ago
Regional Executive Medical Director - Queens Medical Group NewYork-Presbyterian Hospital - Manhattan, New York development team. Coordinates functions such as utilization review, quality assurance programs, medical protocol development and cost management programs/opportunities. Oversees clinical peer review 19 days ago
LVN / LPN - [No Specialty] TactStaff - Astoria, NY, US Coordinates utilization review s of managed care contracts using established guidelines and processes. Ensures all clinical operations comply w with Medicare and Medicaid guidelines and other managed More than 30 days ago
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Sr Utilization Review Spec-Physician FT HUMC Hackensack Meridian Health - Hackensack, New Jersey Overview: The Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records 2 days ago
Chiropractor Telecommute Medical ReviewStream Concentra - Newark, New Jersey of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations. Responsibilities 13 days ago
Medical Director, Part-Time (Remote) Maximus - Newark, NJ or utilization reviews (at least one year of experience) -Must be able to successfully pass credentialing requirements -Knowledge and application of medical management treatment guidelines -Comfortable reviewing 104 USD 3 days ago
Nurse Manager Unit Medical Surgical Unit (5600/ 5700) NYU Langone Health - Brooklyn, New York unit budget in collaboration with Clinical Director. Participates in annual staffing plan/budget review process. Communicates with peers, staff, patients, families and physicians clearly 6 days ago
Physical Therapy Reviewer Centers Plan for Healthy Living - Jamaica, New York in the member’s care. Provides utilization review for preauthorization, concurrent and post service review Apply medical necessity guidelines based on appropriate criteria Utilizes knowledge of community resources 3 days ago
Clinical Director Mitchell Martin - Clark, New Jersey Director is responsible for the supervision of the clinical staff. He/she consults with the CEO, Physician, and Utilization Review Department as needed. The Clinical Director maintains close communication 5 days ago

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