- Molina Healthcare (Yonkers, 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
- 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)
- …for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission). ... **Job Description** ** RN /Case Manager Inpatient Mount Sinai West FT Days...with physicians and managed care companies on concurrent denial appeals 5. 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 (Long Island City, NY)
- …field **Experience Requirements** 5 years of Case Management and 6 years of clinical nurse experience. Previous supervisory experience in Case Management or a ... field. **Licensing and Certification Requirements (if applicable)** Licensed as a registered nurse , Issuing Agency: Department of Health/Office of Professions… more
- Catholic Health Services (West Islip, NY)
- …(BSN) degree required. Master of Science degree strongly preferred. Licensure: New York Registered Nurse ( RN ) License & Registration. Certification: Care ... not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals , Managed Care and Revenue Cycle and Patient Access departments to ensure… more
- Stony Brook University (Stony Brook, NY)
- …**Required Qualifications:** * Master's degree. * Possession of license to practice as a registered nurse in New York State * Certification in ACM or CCM ... case management. **Case Coordination and Patient Management** + Oversee clinical assessments and case coordination processes to ensure quality outcomes… more
- Stony Brook University (Stony Brook, NY)
- …and other duties as required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN license and working history ... is a valuable member of our team, who provides clinical services to our patient population. Qualified candidates will...the hospital stay. + Assist with coverage for UR, Appeals and denials + Actively involved in performance improvement… more