• Clinical Content Specialist - Nursing NCLEX…

    Wolters Kluwer (Colonie, NY)
    … Content Specialist - Nursing, you will work closely with the PreView & ReView Manager/Senior Clinical Content Specialists to plan and deliver high quality NCLEX ... virtually or in person. + Run evaluations, send to facilitator PreView & ReView Content Management Consultant/Senior Clinical Content Specialist and file. +… more
    Wolters Kluwer (08/22/25)
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  • Clinical Review Nurse - Concurrent…

    Centene Corporation (New York, NY)
    …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
    Centene Corporation (09/04/25)
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  • Clinical Regulatory Readiness Manager

    Saratoga Hospital (Saratoga Springs, NY)
    …for organizational compliance. + Collaborate with medical staff affairs team to support OPPE clinical review process and peer review as required. + Acts ... Clinical Regulatory Readiness Manager Location: Saratoga Hospital, 211...offsite mock surveys, unannounced surveys and assists with the review of regulatory standard crosswalks for every dept. in… more
    Saratoga Hospital (06/28/25)
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  • Clinical Reviewer, Nurse-Surgery

    Evolent (Albany, NY)
    …staff and Field Medical Directors. **What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not pass the ... record documentation in order to approve services that meet clinical review criteria. + Conducts ongoing activities which monitor established quality of… more
    Evolent (08/19/25)
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  • Clinical Reviewer, Nurse

    Evolent (Albany, NY)
    …staff and Field Medical Directors. **What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not pass the ... record documentation in order to approve services that meet clinical review criteria. + Conducts ongoing activities which monitor established quality of… more
    Evolent (08/19/25)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Jamaica, NY)
    …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
    Fresenius Medical Center (07/17/25)
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  • Director, Clinical Logistics

    WMCHealth (Valhalla, NY)
    …remote or monitored settings. + Oversees centralized transfer processes, including participation in clinical review of cases as necessary to ensure timely and ... Director, Clinical Logistics Company: WMC Advanced Physician Services PC...Applicant link Job Details: Job Summary: The Director of Clinical Logistics is responsible for overseeing and managing patient… more
    WMCHealth (08/28/25)
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  • Vice President, Clinical Effectiveness

    Option Care Health (Albany, NY)
    … clinical offerings and/or business growth including but not limited to the Clinical Review Board, Clinical Trials Committee, Academic Research Committee. ... patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the… more
    Option Care Health (06/12/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Rochester, NY)
    …identified by the Payment Integrity analytical team; requires decision making pertinent to clinical experience + Documents clinical review summaries, bill ... Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical... review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, responsible for review … more
    Molina Healthcare (09/06/25)
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  • Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …**Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all outpatient and ancillary services requiring authorization. ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
    Centene Corporation (08/02/25)
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