- Centene Corporation (New York, NY)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- Northwell Health (Lake Success, NY)
- … clinical documentation in the patient's medical record through a concurrent review process throughout the patient's inpatient stay. 4.Requests clarification ... of clinical documentation from the physician(s) on a ...date. *Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications… more
- CDPHP (Albany, NY)
- …The Utilization Review (UR) Nurse is responsible for the clinical review and documentation for services requiring prior authorization. This includes ... exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care reviews, post-acute care… more
- UHS (Johnson City, NY)
- …registry by working closely with the TPM and Trauma Registrars to assure accurate, concurrent clinical data abstraction and entry into the trauma registry. The ... Position OverviewThe Trauma Resource Nurse (TRN) has responsibility for concurrent ...to assure the provision of safe, efficient and effective clinical care to all injured patient by continuously monitoring,… more
- Northwell Health (Staten Island, NY)
- **Req Number** 162425 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality patient ... Responsibilities: + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria… more
- Northwell Health (Sleepy Hollow, NY)
- …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. ... collaboration with the health care team. + Conducts chart review for appropriateness of admission and continued length of...and continued length of stay; Facilitates throughput. + Conducts clinical reviews and interacts with third party payers to… more
- Kaleida Health (Buffalo, NY)
- …coding team, Nursing, Patient Management, Quality Department and ancillary staff to perform concurrent analytical review of clinical documentation and coding ... care team. The CDS is also responsible for audit review to identify potential documentation deficiencies in specific records...acute care, medical/surgical or ICU/ED as a licensed Registered Nurse required. 1 year of experience in Clinical… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Clinical Program Manager for Geriatrics and Palliative Medicine supports the Vice Chair of Quality and Clinical Information and oversees ... as a component within the department or larger health system. The Clinical Program Manager leads quality and performance improvement programs in collaboration with… more
- Northwell Health (Melville, NY)
- …care decisions and billing status and ensures compliance with the Utilization Review standard and regulations. Performs concurrent and retrospective utilization ... plus specialized certifications as needed. Preferred Skills 3-5 years experience in Utilization Review , Case Management, and Clinical Appeals. 3-5 years of acute… more
- Insight Global (Lake Success, NY)
- …join their team. The CDI specialist ensures the accuracy and integrity of clinical documentation by conducting concurrent reviews of inpatient records and ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more