- Elevance Health (New York, NY)
- RN Utilization Management - Case Management (Medicaid Long Term Care) JR155671 **Location** : New York or New Jersey. **Virtual:** This role enables ... face-to-face onboarding and skill development as needed. The **Medical Management Nurse ** is responsible for review of...and Experiences:** + A combination of utilization review/ utilization management and Case … more
- BriteLife Recovery (Englewood, NJ)
- …assigned What we need from you? + Minimum of 2-3 years of experience in utilization review, case management , or insurance coordination in a behavioral health ... compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals,… more
- Mount Sinai Health System (New York, NY)
- …assure timely and efficient care to patients, the delivery of comprehensive front-line Case Management services, including utilization management , care ... degree preferred + 5 years of Case Management and 6 years as a clinical nurse...New York State + Certification in case management is preferred Non-Bargaining Unit, BEZ - Utilization… more
- CVS Health (Hoboken, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management ,… more
- Northwell Health (Huntington, NY)
- **Req Number** 161299 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 (North Bergen, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... Qualifications** + Home Health and/or Home Hospice Experience + LTSS experience + Case management and/or discharge planning experience + Managed Care experience… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** RN / Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case ... or a minimum of 3-5 years? experience as a RN in an acute care setting. **Licensing and Certification...patients where utilization review, discharge planning, and/or case management will be needed using standardized… more
- Northwell Health (New Hyde Park, NY)
- …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + ... Submits data to management regarding case management and/or...entry date. + Current License to practice as a Registered Professional Nurse in New York State… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review/Medical and Case Management services for Group Health and Workers' ... disability services for timely return to work. + Provides case management , utilization review, continued...MagnaCare policies and procedures. Essential Qualifications + Currently licensed Registered Nurse in the state of NY,… more
- Outreach Development Corporation (Brentwood, NY)
- F/T Registered Nurse ; Brentwood, NY, US Salary...client(s) to emergency and/or health facility. + The Program RN will attend Supervision with The Nurse ... range: $65000 - $85000 EXCITING. REWARDING. DIFFERENCE MAKING!! The RN assesses health related needs of; monitors ongoing health...all medication calls and health calls as scheduled + Registered Nurse must supervise the License Practical… more
- Mount Sinai Health System (New York, NY)
- …admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using standardized criteria to achieve ... Manager (CM) will be responsible for all aspects of case management for an assigned group of...Sinai St. Luke's and Mount Sinai West, BEZ - Utilization Management - WST, Mount Sinai West… more
- RiseBoro Homecare Inc. (Brooklyn, NY)
- …headed by young adults ages 18 to 25 years old providing health care and management coordination. The Registered Nurse will: + Conduct assessment of the ... ESSENTIAL DUTIES AND RESPONSIBILITIES The Registered Nurse will serve young adults...to: + Positive Youth Development + Recovery-Oriented and Trauma-Informed Case Management + Critical Time Intervention +… more
- Molina Healthcare (New York, NY)
- …authorization requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference ... **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States...meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience**… more
- CenterWell (Hauppauge, NY)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home health ... of care analysis to determine efficiency, the efficacy of case management system as well as any...(NY state requirement) + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …certifications like Diabetes educator, Pediatric Nursing, Gerontological Nursing. * Current licensed Registered Nurse ( RN ) with state licensure; bachelor's ... About The Role Brighton Health Plan Solutions (BHPS) provides Case Management services to its clients. Cases...services to its clients. Cases are maintained by the Nurse Case manager. The Nurse … more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …and as directed by their supervisor and Administrator MDS Coordinator Qualifications: + Registered Nurse with current, active license in state of practice. + ... MDS Coordinator RN The Glengariff Healthcare Center is looking for...state regulations and company policy and procedures.Acts as in-house case manager by considering all aspects of the residents… more
- FlexStaff (Amityville, NY)
- …contact hours of mandatory training requirements such as infection control coursework. + Case Management Certification recommended within two (2) years of the ... Number** 161451 FlexStaff is seeking a Care Delivery Manager ( RN ) for our client, a non-profit healthcare organization providing...license and registration in New York State as a Registered Nurse required. *Additional Salary Detail The… more
- FlexStaff (New York, NY)
- …contact hours of mandatory training requirements such as infection control coursework. - Case Management Certification recommended within two (2) years of the ... care. Serve the organization as a member of the management team, working alongside with all departments and employees...license and registration in New York State as a Registered Nurse required. Additional Requirements: - Be… more
- FlexStaff (New York, NY)
- …contact hours of mandatory training requirements such as infection control coursework. Case Management Certification recommended within two (2) years of the ... care. Serve the organization as a member of the management team, working alongside with all departments and employees...license and registration in New York State as a Registered Nurse required. Additional Requirements: Be legally… more
- Elevance Health (New York, NY)
- …The **LTSS Service Coordinator - RN Telehealth** is responsible for overall management of member's case within the scope of licensure; provides supervision ... and direction to non- RN clinicians participating in the member's case ...chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management , or similar role; or any… more