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By leading market level projects and strategies for provider engagement, this position will drive optimal performance on quality, risk adjustment, utilization management, financial performance, and membership growth.
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Director Care Coordination- Major Responsibilities Criteria A: Establishes and coordinates communication with all Utilization Regulatory Agencies i.e. Qualidigm, NGS, etc., State and Third Party Payers to address Utilization Management Issues and Denials.
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Experience with multiple health plan operational departments (i.e., configuration, medical management, provider operations, customer service, utilization management, regulatory, etc.
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Primarily the job holder is responsible for daily management of OSP construction, installation and maintenance of the Segra OSP network (poles, aerial, buried and underground fiber & copper network facilities) within their assigned area.
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This experience typically includes: monitoring occupant space utilization, energy and water conservation, sustainability and environmental hazards programs; coordinating alteration and renovation projects; gathering information to assess the level of customer satisfaction, i.e., surveys, interviews with tenant contacts, focus groups; monitoring real property budgetary and financial data; and, administration of repair and/or operation and maintenance contracts.
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Ensures assigned Safety Policies maximize compliance with the diverse mandates of agencies such as TJC, CMS, the FDNY, the NYS DOH, the NYC DOMHH, OSHA, the EPA, the NYS DEC, the NYC DEP, the US DHHS. Stays current with institutional policies and procedures, implements and communicates requirements to staff, as appropriate.
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In this role, the Psychiatric Nurse Practitioner will be responsible for providing general clinical care including assessments, medication management and medication administration. Familiarity with OASAS, OMH, and DOH regulations.
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Conduct needs assessment utilizing the UAS-NY/DOH tool to determine members' qualification for Long Term Care services. Comply with NY State DOH guidelines on completion and timely finalization of all UAS assessments.
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Obtains accurate information to complete birth certificate and enter into EBRS to DOH within appropriate timeframe; process corrections as indicated. Collect Birth/Death/Spontaneous Termination of Pregnancy certificate information and submits to DOH within the specified time.
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The Utilization Management Coordinator is responsible for all utilization management activities for assigned cases from admission through discharge, including peer reviews and appeals, in accordance with the Utilization Review Plan, for patient population ages 5 years through 21 years, with significant behavioral health needs and Autism Spectrum Disorders or other developmental disorders.
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Manage the physical environment of the laboratory in accordance with New York State DOH, Joint Commission, OSHA and CLIA regulations. The people of Memorial Sloan Kettering Cancer Center (MSK) are united by a singular mission: ending cancer for life.
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Data Management: Oversee the collection, processing, and utilization of data for training the chatbot, ensuring sensitivity and compliance with data protection regulations. Minimum of 5 years of experience in cloud infrastructure design and management, with a strong focus on Microsoft Azure.
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This position will direct all project level aspects of redevelopment and cap-x projects to include interior (when applicable), exterior renovations and construction improvements of multifamily, single-family rentals, commercial and hospitality properties owned and managed by DLP. This position partners closely with Property Management, Asset Management, Construction, Service Leadership, Revenue Acceleration and Marketing and the Investment teams.
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Our direct care professionals provide counseling and case management services to previously homeless adults living with co-occurring diagnoses of chronic mental illness and substance use disorder.
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CareHarmony is seeking an experienced Licensed Practical Nurse to work 100% Remote – LPN Nurse (LPN) (LVN) with at least 3 years of direct patient-facing work experience; that thrives in a fast-paced environment, is self-motivated, has impeccable attention to detail, and values the impact they can have on a patient’s healthcare journey.
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utilization management doh direct jobs Company: Metroplus Health Plan in Brooklyn, NY
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