- 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
- Yale New Haven Health (Briarcliff Manor, NY)
- …day.Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse ( Rn ) Assesses, Plans, Implements, Evaluates And ... Care For Patients.EXPERIENCEN/ALICENSUREValid State Of Connecticut Registered Nurse LicenseSPECIAL SKILLSBLS Required Additional InformationMed/Surg RN … more
- 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 ... Surg required and Rehab experience preferred.LICENSUREValid State Of Connecticut Registered Nurse LicenseSPECIAL SKILLSBls Certification Required.YNHHS Requisition… more
- 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 ... For Literature Searches Regarding Care For Patients.LICENSUREValid State Of Connecticut Registered Nurse LicenseSPECIAL SKILLSBls RequiredYNHHS Requisition… more
- Yale New Haven Health (Bronx, NY)
- …Patient Throughout The Perioperative Experience. Performs Scrub And Related Duties With A Registered Nurse . Is Responsible For The Immediate Sterile Field And ... Provides Assistance To Nursing And Anesthesia Staff. Assists With Inventory Management As Well As Equipment Maintenance. Provides Any Supportive Duties That… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Crouse Hospital (Syracuse, NY)
- …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data ... 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse ( RN...the quality of care. + Demonstrates proficiency with standard Utilization Review processes. + Responsible for concurrent… more
- Cognizant (Albany, NY)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Guthrie (Binghamton, NY)
- Summary The Registered Nurse ( RN ) Utilization Management (UM) in collaboration with Care Coordination, Guthrie Clinic offices, other physician ... coding, medical record or chart auditing, and experience in utilization management processes preferred. Knowledge of computer...of patient status. 1. Collaborate and set standards with registered nurse ( RN ) case managers… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Utilization Review Specialist ( RN ) Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 Hours ... Review Specialist actively participates in the utilization management of patients and evaluating hospital...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
- CDPHP (Latham, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge of… 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...beneficiary and the Network Provider. + Provides first level RN review for all outpatient and ancillary… more
- Catholic Health Services (Melville, NY)
- …from payors for additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as ... care to MCC in response to physician order, or review of updated clinical information + Acts as a...current with industry standards and business objectives related to Utilization and Care Management as appropriate. +… more
- MVP Health Care (Tarrytown, NY)
- …of clinical nursing experience + At least 2 years of experience in utilization management of sub-acute Medicare reviews + Experience with Medicare guidelines ... To achieve this, we're looking for a **Professional, Sub-Acute RN UM Reviewer - Medicare** to join...interdisciplinary teams to ensure optimal patient care and resource utilization . + Document review outcomes and maintain… more
- Northwell Health (Staten Island, NY)
- …care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness ... license to practice as a Registered Professional Nurse in New York State. + Case Management... and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge… more
- Guthrie (Binghamton, NY)
- …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care...degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant… more
- Stony Brook University (Stony Brook, NY)
- …+ Coordinates the design, development, implementation and monitoring of the organizations case management and utilization review functions. + Manages daily ... but are not limited to:** + Responsible for addressing Utilization management , denials and appeal, discharge and...Qualifications:** * Possession of license to practice as a registered nurse in New York State. *… more
- Northwell Health (Staten Island, NY)
- **Req Number** 167724 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality ... + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria +… more
- CVS Health (Albany, NY)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Independent Health (Buffalo, NY)
- …with regulatory standards, clinical criteria, and member benefit contract. **Qualifications** + Registered Nurse ( RN ) with active, current, unrestricted NYS ... credentials preferred. + Four (4) years of clinical experience required. Utilization Management experience preferred. + Comprehensive knowledge and experience… more
