- Molina Healthcare (New York, NY)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making...these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Centene Corporation (New York, NY)
- …State Licensure required or + LVN - Licensed Vocational Nurse required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... of all appeals requests + Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry… more
- Mount Sinai Health System (New York, NY)
- …for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission). ... **Job Description** ** RN /Case Manager Mount Sinai West FT Days 8a-4p...with physicians and managed care companies on concurrent denial appeals + Communicates clinical information to the… more
- Mount Sinai Health System (New York, NY)
- …for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission). ... **Job Description** ** RN /Case Manager MSH Case Management FT Days** The...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the… more
- Mount Sinai Health System (New York, NY)
- …5 years of case management experience and 5 -7 years of experience as a clinical nurse . Licensing and Certification Requirements (if applicable) License: RN ... in monthly Nursing Department meetings. 5. Works with unit case managers, clinical nurse managers, physicians, and social work to facilitate Interdisciplinary… more
- Mount Sinai Health System (New York, NY)
- …Master's degree preferred + 5 years of Case Management and 6 years as a clinical nurse . + Previous supervisory experience in case management or a related field. ... expected to engage internal and external stakeholders in the improvement of clinical case management, outcomes management processes and throughput. In the absence of… more
- Nuvance Health (Danbury, CT)
- …or a related field preferred * Current licensure as a registered nurse ( RN ) * Minimum of 5 years of clinical experience in an acute care setting * ... and operational oversight for a team of utilization review staff, denials and appeals specialists, non- clinical support staff while partnering with local case… more
- Catholic Health Services (Smithtown, NY)
- …Nursing (BSN) degree required Master of Science degree strongly preferred Licensure: New York Registered Nurse ( RN ) License & Registration Salary Range USD ... nursing supervisors will report to them. The Director of Care Management and Nurse Operations will: Work collaboratively with, but not limited to, Medical Staff,… more