- Molina Healthcare (Yonkers, NY)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must...with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate… more
- Rochester Regional Health (Rochester, NY)
- …LICENSES / CERTIFICATIONS: BLS - Basic Life Support - American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... Job Title: Registered Nurse IDepartment: Utilization Management Location:...UM review findings, initiate and 1st, 2nd, and/or arbitration appeals as needed. Document in all areas that an… more
- Guidehouse (New York, NY)
- **Job Family** **:** Clinical Appeals Nurse **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** + Performs chart ... of care or observation services based on physician certification + Gathers clinical information to conduct continued stay utilization review activities with payers… more
- CenterWell (Albany, NY)
- …or requested. **Use your skills to make an impact** **Required Experience/Skills:** + Registered Nurse or Physical Therapist. + Current state license as a ... and monitoring all payer requests for additional documentation (ADR), appeals and denials. Works with branch staff to gather... Registered Nurse or Physical Therapist. + 5… more
- Crouse Hospital (Syracuse, NY)
- …requirements and contractual agreements. Manager, Care Coordination Requirements: + Licensed as a Registered Nurse in New York State + Bachelor's degree + Five ... hiring a Manager who is responsible for providing day to day management of the RN Care Managers in the department. Pay Range: $95,000 plus based on education and… more
- Elderwood (Liverpool, NY)
- Salary $38.00 - $49.50 / hourly Overview Are you a Registered Nurse ( RN ) with Medicare experience? Do you consider yourself an expert in assessment and ... of Benefits Program + Increased Tuition Reimbursement Program for Clinical Tracks + Shift Differentials + Full Benefits Package... - MDS Coordinator - Qualifications: + Licensed Professional Nurse ( RN licensure preferred) with current license… 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
- Excellus BlueCross BlueShield (Buffalo, NY)
- …peer-to-peer calls in timely manner and provides support for the Case Management (CM) and Registered Nurse ( RN ) reviewers and manages the denial process. + ... for you, we encourage you to apply! Job Description: The position provides clinical leadership and support for the development and implementation of the Children's… 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