- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Clinical Review and Coding Nurse is responsible to attain procedure and diagnosis ... and consistency on referred cases. The RN will perform and coordinate the clinical component of the provider appeal function including communication of the decision… more
- Fresenius Medical Center (Troy, NY)
- …and auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding . + Manages clinic ... **About this role:** As a Clinical Manager with Fresenius Medical Care, you will...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- CDPHP (Albany, NY)
- …The Utilization Review (UR) Nurse is responsible for the clinical review and documentation for services requiring prior authorization. This includes ... reviews for acute and subacute rehabilitation, transportation and DME requests. Review of identified high-cost admissions and extended stays and inpatient… more
- CDPHP (Albany, NY)
- …to be a part of that experience. The Medicaid Special Programs Registered Nurse Assessor/Case Manager is responsible for conducting the initial and reassessments for ... to meet the member's needs. The Medicaid LTSS Registered Nurse Assessors are expected to use critical thinking and...Assessors are expected to use critical thinking and sound clinical judgement when making recommendation for proposed services and… more