• Memorial Sloan-Kettering Cancer Center (New York, NY)
    appeals and acquire authorizations for treatment **Key Qualifications:** + Current NYS Registered Nurse License/Registration and BSN preferred + At least 2-3 ... The MSK Case Management Department is made up of Registered Nurses (RNs), Licensed Practical Nurses (LPNs) and support...you will be responsible for evaluating and responding to clinical and administrative denials referred to Case… more
    DirectEmployers Association (09/11/25)
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  • Clinical Denials and Appeals

    Catholic Health (Buffalo, NY)
    …8-4 with varied hours based on role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for ... include setting up arbitration between parties. This individual provides clinical oversight to the clinical denials...management, operational analysis, information systems or related field + Registered Nurse with a four (4) year… more
    Catholic Health (10/01/25)
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  • UR Registered Nurse

    Cognizant (Albany, NY)
    …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...related to clinical denial management and managing clinical denials from Providers to the Health… more
    Cognizant (10/09/25)
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  • Denials and Appeals Mngmt Cord

    WMCHealth (Valhalla, NY)
    Denials and Appeals Mngmt Cord Company: WMC Advanced Physician Services PC City/State: Valhalla, NY Category: Clerical/Administrative Support Department: ... Details: Job Summary: Decrease the monies lost to insurance companies due to denials . Generate appropriate appeals , both retrospective and concurrent, based on… more
    WMCHealth (10/17/25)
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  • Director of Care Coordination ( RN )

    Catholic Health Services (West Islip, NY)
    …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
    Catholic Health Services (10/16/25)
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  • Inpatient Clinical & Coding Specialist…

    Independent Health (Buffalo, NY)
    …American Health Information Management Association (CCS-H, CCS-P), Certification Denials and Appeals Management (C-DAM), or NYS licensed RN or LPN required. ... coding guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records, consultation with… more
    Independent Health (10/04/25)
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  • Case Manager, Medicaid Long Term Support Program

    MVP Health Care (Rochester, NY)
    …York** **Qualifications you'll bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 ... after hire. + At least 3 years of recent clinical and Case Management experience. Experience working in a...maintain cost-effectiveness and manage Medical Loss Ratio (MLR). + Appeals & Denials : Participate in the … more
    MVP Health Care (10/28/25)
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  • LPN Care Coordinator - Hereditary Risk Program…

    Guthrie (Binghamton, NY)
    …needed for patient that have arrived without orders. Prepare educational materials for the RN Nurse Navigator for Chemo Education Visits per the instruction and ... of coverage of ordered medications. + Coordinate and complete appeals for denials as needed + Monitor...offices and for DBL office as needed Coverage for RN Nurse Navigator + Coordinate and facilitate… more
    Guthrie (09/09/25)
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  • LPN Care Coordinator - Cancer Center - Full Time

    Guthrie (Corning, NY)
    …needed for patient that have arrived without orders. Prepare educational materials for the RN Nurse Navigator for Chemo Education Visits per the instruction and ... of coverage of ordered medications. * *Coordinate and complete appeals for denials as needed * *Monitor...offices and for DBL office as needed Coverage for RN Nurse Navigator * *Coordinate and facilitate… more
    Guthrie (08/08/25)
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