- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time) Schedule: Monday - Friday, ... Days SUMMARY: Review all inpatient medical necessity denials for the health...inpatient medical necessity patient class as needed. Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management… more
- Rochester Regional Health (Rochester, NY)
- …necessary and delivered at the most appropriate level; actively participate in the concurrent review process and communicate/intervene with third party payors to ... a holiday every other year. Sign-On Bonus: Yes SUMMARY:As a Registered Nurse - Care Manager, your excellent interpersonal, leadership and collaboration skills ensure… more
- FlexStaff (Lake Success, NY)
- **Req Number** 177188 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
- Albany Medical Center (Albany, NY)
- …environment. + Basic knowledge of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or ... financial constraints. + Provides collaborative care management with the primary nurse in assessing for discharge planning needs, coordinating appropriate resources… more
- WMCHealth (Valhalla, NY)
- Nurse , Performance Improvement Trauma Coordinator Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Nursing/Nursing Management ... and works closely with the Trauma Registry to ensure accurate concurrent data collection and identification of performance improvement occurrences. The Performance… more
- Northwell Health (Sleepy Hollow, NY)
- …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. ... patient in collaboration with the health care team. + Conducts chart review for appropriateness of admission and continued length of stay; Facilitates throughput.… more
- Northwell Health (Lake Success, NY)
- …to clarify clinical documentation in the patient's medical record through a concurrent review process throughout the patient's inpatient stay. 4.Requests ... expected risk of mortality, and complexity of care provided. Responsible for concurrent inpatient medical record reviews for Medicare, Medicaid and all commercial… more
- Mount Sinai Health System (New York, NY)
- …the clinical information requested by the managed care companies as part of the concurrent review in a timely fashion. c. Provides clinical information requested ... Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or a minimum… more
- Centene Corporation (New York, NY)
- …am - 5:00 pm with holiday rotation.** **Position Purpose:** Manages Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review ... and facilitates operations within utilization management. + Manages prior authorization, concurrent review , and retrospective clinical review team… more
- Saratoga Hospital (Saratoga Springs, NY)
- …Specialist, you will be responsible for timely, reliable, and accurate concurrent and retrospective medical record reviews and abstraction of clinical data ... issues as they arise. What You'll Do + Responsible for performing concurrent and retrospective clinical reviews to support core measure and accrediting body… more