- Trinity Health (Troy, NY)
- …administrative requirements for Utilization Management and works collaboratively with Utilization Management/ Concurrent Review Nurse , physicians, staff and ... possible concurrent denials, forwards information to the appropriate Utilization Management/ Concurrent Review Nurse within identified process standards *… more
- Mount Sinai Health System (New York, NY)
- …information requested by the managed care companies as part of the concurrent review in a timely fashion. c. Provides clinical information requested by the ... for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission).… more
- Mount Sinai Health System (New York, NY)
- …information requested by the managed care companies as part of the concurrent review in a timely fashion. 3. Provides clinical information requested by the ... for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission).… more
- Mount Sinai Health System (New York, NY)
- …/ appeals as specified by Insurance / State & Federal regulation. + Enters concurrent review information for Review Nurses in Allscripts + Obtains/Prepares ... + Process Mail - Sort, identifies location and distribute to appropriate departments + Monitors Concurrent Nurse denial phone calls for UM Nurse to follow +… more
- Northwell Health (Forest Hills, NY)
- …In concert with attending physician.Responds to third party payer requests for concurrent clinical information providing all relevant documentation to ensure ... Masters Degree, preferred.Current license to practice as a Registered Professional Nurse in New York State.Patient Review Instruments (PRI) Certification… more
- Guthrie (Corning, NY)
- …two (2) years of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who holds a bachelor's degree in a ... in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to...to the case management process. Certified to complete Patient Review Instruments (PRIs). Has a working knowledge of the… more
- Guthrie (Binghamton, NY)
- …two (2) years of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who holds a bachelor's degree in a ... Case Manager utilizes industry accepted processes for achieving optimal patient, clinical , and operational outcomes timely, coordinated, and in cost effective… more
- Northwell Health (Staten Island, NY)
- …Patients Discharge Instruction Sheet and the Patient Transfer Sheet. + Ensures Patient Review Instrument (PRI) is completed and reflects clinical profile of the ... clinical pathways, variance analysis and trending, quality management/utilization review and home care/discharge planning, preferred. + Keeps abreast of… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …between BH and PH care across the UM/ CM staff. + Participates in clinical peer review recruitment and supervision. + Collaborates with Provider Relations staff ... 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
- UHS (Johnson City, NY)
- …perspective. The Trauma Performance Improvement Coordinator will conduct retrospective and concurrent case reviews of the critically injured patient from time of ... or related Healthcare field. Preferred: + 5 years of clinical experience in critical care, trauma, and/ or ER....Current CPR Certification. + Current provider certification in Trauma Nurse Core Course (TNCC) or Advanced Trauma Care for… more