- Centene Corporation (New York, NY)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... have a New York State nursing license.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and appropriate… more
- YAI (Manhattan, NY)
- …disabilities and their families. Key/Essential Functions & Responsibilities: + Report to the nurse manager or nurse supervisor, at Premier HealthCare (PHC). Meet ... on a weekly basis for supervision to review duties and responsibilities. + Accountable for the day-to-day...and followed as directed. + Assume duties of the nurse supervisor when needed and provide coverage for and… more
- Evolent (Trenton, NJ)
- …clients as scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are performed within the RN/LVN/LPN scope of practice, under… more
- Elevance Health (Woodbridge, NJ)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
- Penn Medicine (West Windsor, NJ)
- …meet standards for competent professional nursing practice as specified in the Clinical Nurse 2 position description. Exhibits PMPH organizational behavioral ... competency in all Knowledge, Skills and Attitudes for a Clinical Nurse 1 in addition to: b....systems are based. Credentials: + Active New Jersey Registered Nurse License (required prior to first day… more
- Penn Medicine (Plainsboro, NJ)
- …shape our future each day. Are you living your life's work? Summary: + The Clinical Nurse 2 Colleague possesses the knowledge, skills and the attitude to ... for competent professional nursing practice as specified in the Clinical Nurse 2 position description. The ... - NJ (Required) + Active New Jersey Registered Nurse License (required prior to first day… more
- Penn Medicine (Plainsboro, NJ)
- …shape our future each day. Are you living your life's work? Summary: + The Clinical Nurse 2 Colleague possesses the knowledge, skills and the attitude to ... for competent professional nursing practice as specified in the Clinical Nurse 2 position description. The ... - NJ (Required) + Active New Jersey Registered Nurse License (required prior to first day… more
- City of New York (New York, NY)
- …level of functioning and self-sufficiency by providing comprehensive, integrated, individualized clinical and support services. CAS works with other programs at HRA ... Services (VPS) Unit is recruiting for two (2) Psychiatric Nurse Practitioner for the roles below. Under the supervision...1. Obtain referrals and schedule for evaluations from the Clinical Intake Unit for assignment of cases. Coordinate time… more
- Veterans Affairs, Veterans Health Administration (Lyons, NJ)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse or physician for appropriateness and conformity ... qualify for credit toward annual leave accrual, based on prior [work experience] or military service experience. Parental Leave:...patient information. Completed work should need only a general review by a registered nurse (RN) or… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The nurse anesthetist is an advanced practice nurse (CRNA). Within this role, under the supervision of an Attending Anesthesiologist, the ... of Science degree in NursingMasters Degree in Nursing with a specialization in nurse anesthesia preferred or a graduate of an accredited program in Nurse… more
- Sharecare (Trenton, NJ)
- … helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- IQVIA (New York, NY)
- …written English. + Must possess a valid driver's license and will be subject to a review of driving record prior to hire. + Must complete a drug screening and ... Mobile Nurse Practitioner - Per Diem, In-Home Services **Location:**...within designated geographic area) **About the Role:** IQVIA's In-Home Clinical Solutions team seeks a qualified and dedicated Mobile… more
- Project Renewal, Inc. (New York, NY)
- Title: Nurse Care Manager for Drug User Health Services...+ Ability to speak and write in Spanish + Prior clinical experience working with patients with ... C infection. Position Overview: Project Renewal is seeking a Nurse Care Manager (NCM) for Drug User Health Services...Health. The ideal candidate must possess not only the clinical knowledge and skills to participate in individual patient… more
- YAI (Manhattan, NY)
- …to live, love, work, and learn . We are currently seeking a Registered Nurse Supervisor in our residential system. The ideal candidate will have experience in the ... of direct care staff in the monitoring of the medical systems. Additionally, the nurse will participate in team meetings and provide medically related in services to… more
- CVS Health (Huntingdon Valley, PA)
- …of network management and clinical coverage policies. Through the use of clinical tools and information/data review , conducts an evaluation of member's needs ... - RN with current unrestricted Virginia state licensure required - 3+ years clinical experience as a Registered Nurse (ie med surg, behavioral health,… more
- Penn Medicine (Cherry Hill, NJ)
- …the State of New Jersey and Commonwealth of Pennsylvania, MSN, and certification as a Nurse Practitioner. + Prior to employment, the CRNP must be reviewed by the ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- Elevance Health (Woodbridge, NJ)
- **Telephonic Nurse Case Manager II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training ... different states; therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for performing care management within… more
- Trinity Health (Langhorne, PA)
- …significant abnormal findings and problems to the physician and/or anesthesiologist. . Review chart for patient optimization and completeness prior to surgery. ... . Serve as a resource to nurse navigators for clinical decision making. . Performs other duties as assigned. **Our Commitment to Diversity and Inclusion**… more
- Prime Healthcare (Bristol, PA)
- …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license + Grandfathered prior to April 1, 2015. Minimum 5 ... designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a...to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more
- Evolent (Trenton, NJ)
- …The Specialty Appeal nurses work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators who set up the ... appeal, Physicians and other Clinicians who review the appeal, and managers for direction and leadership. The Appeals teamwork strategies and opportunities for… more