See more Collapse

Utilization Review Analyst

4 weeks ago


Bronx, United States Comunilife,Inc. Full time

**Comunilife Inc.** is looking for a **Utilization Review Analyst **for its new **Rehabilitation and Tenancy Support Services Program (RTS) **Thisposition reports to the **RTS Program Manager** and will support the 6 program directors and their staff that have OMH supportive housing. This program was established as of January 1, 2023, and allows agencies that provide housing services to clients in units funded by NYS Office of Mental Health (OMH) to bill Medicaid for certain services. The program is designed to assist individuals who are transitioning from institutional care or temporary settings into permanent housing. The individual receives RTS services which help them to develop independent living skills and achieve housing stability. The services focus on reducing disabling symptoms related to mental illness and substance use and increasing individuals’ ability to maintain a household and integrate into the community. **This position is eligible for Comunilife’s generous benefits and paid time off package and is salaried up to $50,000 a year.**

**Essential functions**:

- Analysis of CAIRS and AWARDS data
- Development of reports, data reviews, charts/graphs and other tools to display data and data findings.
- Responsible for integrity of data; identification of data discrepancies and support to RTS program staff to resolve any issues that arise
- Responsible for ensuring compliance with policies and procedures in compliance with Federal, State and City Laws, rules and regulations
- Ensure that Quality Improvement Policies and Procedures are follow as required
- Ensure program compliance with OMH contract requirements
- Regularly review and monitor assessors output activities to ensure that benchmark are met.
- Monitor data in CAIRS and AWARDS to ensure that data integrity in compliance with Medicaid billing requirements.
- Provide oversight in maintaining and securing individual files and records to ensure that files are kept complete, current, and readily identifiable from other Comunilife programs. Ensure that all client records are maintained by Comunilife for a minimum of seven (7) years after the expiration of the contract.
- Maintain all documents necessary for a quality assurance and improvement review by Comunilife or OMH.

**Qualifications**

**Education and Experience Requirement(s)**

Bachelor’s Degree in the liberal arts, including but not limited to Psychology, social work, public health, health administration, or related field; and two (2) years or more of experience in program development data analysis, research, auditing or program administration. Proficient in the use of technology including excel, project management tools, flow charting software, powerpoint and other analytical software tools is essential.

Comunilife is an EEO employer and provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Pay: $22.00 - $27.00 per hour

Expected hours: 35 per week

**Benefits**:

- 401(k)
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Vision insurance

Schedule:

- 8 hour shift
- Day shift
- Monday to Friday

**Education**:

- Bachelor's (required)

Ability to Relocate:

- Bronx, NY 10451: Relocate before starting work (required)

Work Location: In person


We have other current jobs related to this field that you can find below

  • Travel Nurse RN

    2 weeks ago


    Bronx, United States Medical Solutions Full time

    Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Bronx, New York.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNDuration: 13 weeks37 hours per weekShift: 8 hours, daysEmployment Type: Travel We’re seeking talented healthcare professionals whose adventure...

  • Analyst

    1 month ago


    Bronx, United States Nexus Staff Inc. Full time

    Job Title: Analyst Employment Type: Contract Work Hours: 40+hrs./week Work site: 100% Onsite Location: Bronx, NY 10473 Salary: $ 33.50/hrMinimum Education: Bachelor's degree preferred. Work Experience: Strong data analytical skills required. Proficiency in Microsoft Office applications required. Strong expertise in Excel for running reports, filtering,...

  • Utilization Manager

    2 months ago


    Bronx, United States Acacia INC Full time

    Details: Acacia Network, the leading Latino integrated care nonprofit in the nation, offers the community, from children to seniors, a pathway to behavioral and primary healthcare, housing, and empowerment. We are visionary leaders transforming the triple aim of high quality, great experience at a lower cost. Acacia champions a collaborative environment to...


  • Bronx, United States Greenlife Healthcare Staffing Part time $50

    JOB TITLE (#25035): Registered Nurse Maternal Reviewer / Per Diem - Metropolitan AreaMinimum of 2 years of clinical practice experience in pediatric/adolescent/reproductive health care is preferredGreenlife Healthcare Staffing is currently seeking a Registered Nurse Maternal Reviewer to fill an opening with a Non-profit organization located in New...

  • Travel Nurse RN

    2 weeks ago


    Bronx, NY, United States Medical Solutions Full time

    Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Bronx, New York.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNDuration: 13 weeks37 hours per weekShift: 8 hours, daysEmployment Type: Travel We’re seeking talented healthcare professionals whose adventure...

  • Procurement Analyst

    4 weeks ago


    The Bronx, United States City of New York Full time

    The Department of Records and Information Services is seeking to hire a Procurement Analyst to work in the Administration division. The duties for this position will include but are limited to: Purchasing & Payments: -Preparing procurement documentation for the agency including purchase requisitions, memos and personal expense reimbursement. Processing...


  • Bronx, United States ba system solution Full time

    Company Description Welcome To BA System Solutions, We Are A Leading Technology Service Provider And Software Development Company Delivering Comprehensive Solutions In Customized Software Development, Application Development, Mobile Apps Development, Software Testing And Application, Mobile Apps Re-Engineering Services. Our Team Of Qualified Professionals...

  • Procurement Analyst

    1 month ago


    The Bronx, United States City of New York Full time

    The NYC Department of Environmental Protection (DEP) enriches the environment and protects public health for all New Yorkers by providing 1.1 billion gallons of high quality drinking water, managing wastewater and stormwater, and reducing air, noise, and hazardous materials pollution. DEP is the largest combined municipal water and wastewater utility in the...


  • Bronx, United States ADEX Full time

    Position Description: The Superintendent's primary role is to provide overall field management and administration to field employees, subcontractors, vendors, and suppliers. The Superintendent may manage a major project or many projects simultaneously. Core Responsibilities: Deliver a quality project safely, on time, within budget and with focus on...


  • Bronx, United States Pyxai, Inc. Full time

    Job Description Do you have a background assisting underwriting? Credit Reporting Analyst will support Bank Strategy and assure compliance, through proper, accurate and compliant reporting. The role will also support the design, implementation and enhancement of credit/lending reporting, working with automation, integration and verification of key data,...

  • Fleet Staff Analyst

    1 month ago


    The Bronx, United States City of New York Full time

    -Provide professional and technical work in the preparation and conduct of administrative processes and procedures. -Assist in the planning, coordination and implementation of agency personnel administrative activities including the intake and processing of staff driver applications, maintaining an accurate database of agency drivers, and providing support...


  • The Bronx, United States Blackstone Talent Group Full time

    Blackstone Talent Group, an award-winning technology consulting and talent agency is seeking a Sr. Infor Visual ERP Business Analyst – Discrete Mfg to join our Client's team.Client is seeking an experienced and highly skilled Senior Business Analyst with expertise in Infor Visual ERP and extensive knowledge in discrete manufacturing for complex...


  • The Bronx, United States Blackstone Talent Group Full time

    Blackstone Talent Group, an award-winning technology consulting and talent agency is seeking a Sr. Infor Visual ERP Business Analyst – Discrete Mfg to join our Client's team.Client is seeking an experienced and highly skilled Senior Business Analyst with expertise in Infor Visual ERP and extensive knowledge in discrete manufacturing for complex...


  • The Bronx, United States City of New York Full time

    OPEN TO PERMANENT PRINCIPAL ADMINISTRATIVE ASSOCIATES AND THOSE WHO ARE REACHABLE ON THE CIVIL SERVICE LIST. AGENCY DESCRIPTION Established in , the New York City Department of Health and Mental Hygiene (the NYC Health Department) is the oldest and largest health department in the country. Our mission is to protect and improve the health of all New...

  • Denials & Appeals MGR

    2 months ago


    Bronx, United States St. Barnabas Full time

    Job Description 1. Promotes a safe, cooperative and professional health care environment to ensure optimum patient care (as per HR Policy 113c). 2. Adheres to all hospital policies, procedures, rules and regulations, including but not limited to, absenteeism, ETIME, cellular telephone usage, dress code and rules of conduct. 3. Makes Customer Service a...


  • Bronx, United States BronxCare Health System Full time

    Overview: As the Director of Population Health Analytics within the Ambulatory Care Department of our large health system, you will lead a team responsible for analyzing clinical and operational data to support population health management initiatives. You will oversee the development and implementation of data-driven strategies to improve patient outcomes,...


  • Bronx, United States BronxCare Health System Full time

    Overview: The Case Manager will coordinate care using a collaborative approach with the multidisciplinary team in identifying the required services needed to meet an individuals health needs while hospitalized. The UCMRN will be expected to identify, intervene and expedite issues which many adversely affect the length of stay and quality of care by...


  • Bronx, United States BronxCare Health System Full time

    Overview: Secure pre-authorizations for medical and ancillary services. Communicate on a daily basis with practice managers, clinicians and staff to ensure that visits are appropriately registered, and meet all insurance pre-authorization requirements. Responsibilities: - Establish and maintain positive relationships with patients, visitors, and other...


  • Bronx, United States BronxCare Health System Full time

    Overview: Secure pre-authorizations for medical and ancillary services. Communicate on a daily basis with practice managers, clinicians and staff to ensure that visits are appropriately registered, and meet all insurance pre-authorization requirements. Posting internally from Oct 23-Oct 30 Responsibilities: - Establish and maintain positive relationships...


  • Bronx, United States FlexCare Imaging Full time

    FlexCare Imaging is seeking a travel Radiology Technician for a travel job in Bronx, New York. Job Description & Requirements Specialty: Radiology Technician Discipline: Allied Health Professional Start Date: 07/22/2024 Duration: 14 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel Looking for a great Travel Radiology Technician Job in...