- Stony Brook University (Stony Brook, NY)
- Registered Nurse (T&RC) - Blood Donor - Per Diem **Position Summary** At Stony Brook Medicine, our Registered Nurses are critical members of the team who ... while adhering to a medical regimen. **Duties of a Registered Nurse in the Blood Donor Department...Donor and Therapeutic Apheresis as assigned.. + Perform blood utilization quality assurance, donor related work as assigned. +… more
- Stony Brook University (Stony Brook, NY)
- …development, implementation and monitoring of the organizations case management and utilization review functions. + Manages daily operations, which includes ... of resources, coordination of care across the continuum, utilization review , discharge and transition planning and...Qualifications:** * Possession of license to practice as a registered nurse in New York State. *… more
- New York State Civil Service (Bronx, NY)
- NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York City Children's Center - Bronx Campus, P27076 Occupational ... New York City Children's Center - Bronx Campus is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and efficiency… 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
- Fresenius Medical Center (New York, NY)
- …and programs. Collaborates with the Medical Director and the Clinical Coordinator /Charge Nurse or Nurse Supervisor regarding the provision of quality patient ... closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse manager, the Medical Director, and the… more
- WMCHealth (Valhalla, NY)
- …implementation or investigation of the procedures specified in the Quality Management, Utilization Review and Discharge Planning Program at Westchester Medical ... the New York State Department of Education, as a registered professional nurse . Training and Experience: three...of which must have been in the area of utilization review , quality assurance, risk management or… more
- Northwell Health (Sleepy Hollow, NY)
- …five (5) years of job entry date. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as ... + Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + Submits… 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 highly motivated,...communications within the facility with the director of nursing, nurse managers, and admissions coordinator to assist in development… more
- Molina Healthcare (Yonkers, NY)
- JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring timely claims ... a hospital setting, including at least 1 year of utilization review , medical claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active… more
- Fresenius Medical Center (Yonkers, NY)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Centene Corporation (New York, NY)
- …+ LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: $26.50 - $47.59 per hour Centene ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
- Molina Healthcare (Yonkers, NY)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience,… more
- Mount Sinai Health System (New York, NY)
- …Additional Detail** + Licensure: New York State License with current registration as a registered nurse . + State Certification: Certified by the New York State ... the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion...follows: a. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
- Mount Sinai Health System (Long Island City, NY)
- …REQUIREMENTS** Licensure: New York State License with current registration as a registered nurse . State Certification: Certified by the New York State ... as follows: a.Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR...the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion… more
- Mount Sinai Health System (New York, NY)
- …Additional Detail** 1. Licensure: New York State License with current registration as a registered nurse . 2. State Certification: Certified by the New York State ... the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion...follows: a. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
- City of New York (New York, NY)
- …requirement above, candidates must have three years of full-time satisfactory experience as a Registered Nurse , two of which must have been in a supervisory ... with the referring agency and the client's caseworker. 2. Review all available clinically relevant material, including referral information,...have three years of full-time satisfactory experience as a Registered Nurse , one of which must have… more
- Nuvance Health (Danbury, CT)
- …principal liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate ... level within the care continuum. Provides clinically based concurrent review of the medical record to assess and procure...in Nursing and minimum of three years job-related experience. Registered Nurse license State of CT with… more
- Molina Healthcare (Yonkers, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Yonkers, NY)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Centene Corporation (New York, NY)
- …required or + LVN - Licensed Vocational Nurse required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required or + LCSW- ... applicable criteria, and analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with State, Federal and NCQA… more
