- Yale New Haven Health (Yonkers, NY)
- …day.Works under the supervision of the Nurse Manager/Clinical Coordinator. The Registered Nurse ( RN ) assesses, plans, implements, evaluates and ... level 2 or 3 experience preferredLICENSUREValid State of Connecticut Registered Nurse licenseSPECIAL SKILLSBLS required. NRP required within… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Utilization Review Specialist ( RN ) Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 Hours ... (Full-Time) Schedule: Monday - Friday, Days SUMMARY:The Utilization Review Specialist actively participates in...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review , ... York State NY Zip Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited to conducting daily … more
- Centene Corporation (New York, NY)
- …clinical license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a...beneficiary and the Network Provider. + Provides first level RN review for all outpatient and ancillary… more
- Guthrie (Binghamton, NY)
- Summary The Registered Nurse ( RN ) Utilization Management (UM) in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, ... of patient status. 1. Collaborate and set standards with registered nurse ( RN ) case managers...System process improvement. + Denials Adjudication 1. Facilitate review of rejected medical claims using clinical evidenced based… more
- City of New York (New York, NY)
- …required; make professional recommendations accordingly. - Keep abreast of medical and utilization review techniques and developments relative to the nursing ... Nurse in the Bureau of Medical and Professional Review (BMPR) of Home Care Services Program. As the...- 50935 Qualifications 1. A valid New York State Registered Nurse License and completion of one… more
- Mount Sinai Health System (New York, NY)
- …+ Experience Requirements + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management...System is one of the largest academic medical systems in the New York metro area, with more… more
- Northwell Health (Staten Island, NY)
- …case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. + Keeps ... utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of...Nursing, required. + Current license to practice as a Registered Professional Nurse in New York State.… more
- Guthrie (Binghamton, NY)
- …or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or ... of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who...in an acute care setting with strong care management, utilization review , and payer knowledge. A Case… more
- Cognizant (Albany, NY)
- …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- CenterWell (Westbury, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... 40 hours per week Respiratory Therapist (RT) / Respiratory Nurse ( RN ) We are searching for a...of respiratory disease and diseases that affect the respiratory system . o Ability to use respiratory therapy equipment. o… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... RN Supervisor Case Management - Full Time -...Performs related duties as assigned. Education/Experience Requirements REQUIRED: + Registered Nurse licensed in State of New… more
- Whitney Young Health Center (Albany, NY)
- Registered Nurse ( RN ) Care Manager - Women's Health/Pediatrics (Req 100987) Albany, NY (http://maps.google.com/maps?q=920+Lark+Drive+Albany+NY+USA+12207) ... principles of Patient Centered Medical Home (PCMH), the Care Manager ( RN ) will demonstrate professional nursing practice, excellent communication and critical… more
- Veterans Affairs, Veterans Health Administration (Syracuse, NY)
- …by collaborating with members of the interdisciplinary team. The Referral Coordination Team (RCT) Registered Nurse ( RN ) ) is responsible for executing a ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements,… more
- Fresenius Medical Center (New York, NY)
- …+ Collaborates closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse manager, the ... + Addressing patient concerns, issues, and questions including the review of patient satisfaction surveys. + Developing and communicating...CQI tools. + Works with the Clinical Coordinator /Charge RN or Nurse Supervisor and Medical Director… more
- Fresenius Medical Center (Amsterdam, NY)
- …management company. Maintains current knowledge of disease management software and systems as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, ... for the integrity and safety of the facility water system . + Must be knowledgeable in the operation of...+ Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic,… more
- Bassett Healthcare (Cooperstown, NY)
- …before 12/19/17 are/remain exempt from this requirement. Experience: + Minimum 5 years of Registered Nurse experience, 3 years must be in relevant practice area, ... of safe patient care utilizing the nursing process. The RN assesses, plans, delivers, coordinates, integrates, and evaluates nursing...to perform as preceptor, required + Minimum 2 years Registered Nurse experience in relevant practice area,… more
- Catholic Health (Buffalo, NY)
- …finance, business management, operational analysis, information systems or related field + Registered Nurse with a four (4) year degree and Unrestricted NYS ... payers) and internal stakeholders including, but not limited to, Utilization Review , Case Management, Clinical Documentation Integrity,...RN license, preferred + Holds, or will obtain within… more
- Bassett Healthcare (Cooperstown, NY)
- …continuous improvement in both areas. + Refers cases and issues to Case Review , Utilization Committee, Medical Director, and Director of Quality in compliance ... of life possible. What you'll do The Case Manager RN supports the physician and interdisciplinary team in facilitating...setting, preferred Licensure/Certifications: + Current NYS licensure as a Registered Professional Nurse , if applying as a… more
