- Aequor (New York, NY)
- …occupational nursing professional Minimum experience of 1-3 years in case management, utilization review and/or quality assurance Experience in episodic care, ... wellness care and counseling of adults Proficiency in use of electronic medical record keeping systems desirable BLS certification required Optional: Case Management and COHN-S certificationsMajor Responsibilities: Assist in coordination of clinical… more
- The University of Vermont Health Network (Plattsburgh, NY)
- …Current New York State Registered Nurse license required.2. CCM Preferred. Utilization review and discharge planning experience preferred.3. Three years of ... Department at Champlain Valley Physicians Hospital (CVPH) in Plattsburgh, NY.GENERAL SUMMARY:The Utilization Review RN monitors, collects and analyzes data and… more
- Albany Medical Center (Albany, NY)
- Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Utilization Review Nurse Salary Range: $31.28 - $51.61 per hour ... for assigned patients. Qualifications and Ideal Characteristics + Registered nurse with a New York State current license. +...Basic knowledge of computer systems with skills applicable to utilization review process. + Excellent written and… more
- Glens Falls Hospital (Glens Falls, NY)
- …be foundhere. **Job:** **Nursing - Case Management* **Title:** *Registered Nurse - Utilization Review Nurse - Care Management (Sign-On Bonus for ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and removing… more
- CDPHP (Albany, 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 ... for acute and subacute rehabilitation, transportation and DME requests. Review of identified high-cost admissions and extended stays and...acute care experience is required as a Licensed Practical Nurse . + Minimum of two (2) years Utilization… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards. * While performing utilization review identifies areas for clinical documentation improvement and ... Work Work Shift: Day (United States of America) Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. Salary:… more
- Insight Global (New York, NY)
- Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more
- Elevance Health (Middletown, NY)
- …medical decisions to members and providers. **Job Summary:** + Perform physician-level case review , following initial nurse review , of Medical Oncology ... regimens and supportive care. + Perform physician-level case review , following initial nurse review ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- Catholic Health (Lockport, NY)
- …Rotation Hours: 8:00a-4:00p, 9:00a-5:00p, 10:00a-6:00p, 11:00a-7:00p Summary: The RN Care Manager, Utilization Review / Transitions of Care, as an active member ... the Care Management and interdisciplinary care team, provides comprehensive Utilization Review and transitions of care services...Education, or BS in Health related field + Registered Nurse , licensed ( unrestricted ) in New York State… more
- Crouse Hospital (Syracuse, NY)
- Utilization Management RN has well-developed knowledge and is proficient with standard Utilization Review processes. The Utilization Management RN is an ... on their appropriate admission status. This individual will support the Utilization Management process by maintaining effective and efficient processes for… more
- University of Rochester (Rochester, NY)
- …work is remote with some on-site requirements as needed. **Qualifications:** RN with Utilization Review experience preferred; 3-5 years of recent acute hospital ... Responsibilities **General Description:** The Utilization Management Nurse role is a...insurance companies. The UM RN is responsible for the review of clinical documentation utilizing evidence-based criteria to support… more
- CDPHP (Albany, NY)
- …one (1) year clinical experience required. + A minimum of two (2) years quality/ utilization review experience in an HMO, managed care organization, or similar ... invites you to be a part of that experience. The Clinical Review and Coding Nurse is responsible to attain procedure and diagnosis coding accuracy and… more
- Bassett Healthcare (Cooperstown, NY)
- …discuss specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Dialysis units is accountable for the ... needs. The RN contributes to the support of patients through interdisciplinary teamwork. Registered Nurse I: The RN I status is only appropriate for a new nurse… more
- Albany Medical Center (Albany, NY)
- …Demonstrates experience in the referral process and use of community resources. 2. Utilization Review a. Reviews data from admission screening to clarify ... changing environment. 8. Basic knowledge of computer systems with skills applicable to utilization review process. Mission, Core Values and Service Excellence 1.… more
- Bassett Healthcare (Cooperstown, NY)
- …with no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. The Registered Nurse II, Acute Care ... with no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. The Registered Nurse II, Acute Care… more
- Bassett Healthcare (Cooperstown, NY)
- …a principle liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate bed ... America's Best-In-State Employer 2022! What you'll do The Emergency Department Registered Nurse Clinical Case Manager (Unit C3 RN) will facilitate transitional care… more
- Bassett Healthcare (Cooperstown, NY)
- …to established department procedures. Participates or leads committees as directed by the Nurse Manager, as noted in portfolio review . Plans and implements ... with no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. The Assistant Nurse Manager assists the… more
- The Mount Sinai Health System (New York, NY)
- **Job Title: Nurse Practitioner - Pediatrics Nursing - MSH - FT - Days** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion… more
- Bassett Healthcare (Cooperstown, NY)
- …a Forbes America's Best-In-State Employer 2022! What you'll do The Registered Professional Nurse II Acute Care is accountable for the delivery of safe patient care ... no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to… 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 ... Medicaid Eligibility Unit is responsible for the Medicaid eligibility review and processing of initial applications, change actions, and...Nurse in the Bureau of Medical and Professional Review (BMPR) of Home Care Services Program. As the… more
