- CDPHP (Latham, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... 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)
- Position OverviewThe Trauma Resource Nurse (TRN) has responsibility for concurrent trauma performance improvement and patient safety activities for the Trauma ... by working closely with the TPM and Trauma Registrars to assure accurate, concurrent clinical data abstraction and entry into the trauma registry. The TRN maintains… more
- Crouse Hospital (Syracuse, NY)
- …maintaining the quality of care. + Demonstrates proficiency with standard Utilization Review processes. + Responsible for concurrent and continued stay ... programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage data and client care as it relates… more
- Cognizant (Albany, NY)
- …to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical ... as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,...have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization… more
- Northwell Health (Staten Island, NY)
- **Req Number** 167724 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 (Mount Kisco, 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
- Guthrie (Binghamton, NY)
- Summary The Registered Nurse (RN) Utilization Management (UM) in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and payers, ... payers. The UM RN responsibilities include performing a variety of concurrent and retrospective UM-related clinical reviews and revenue cycle functions ensuring… more
- Mount Sinai Health System (Long Island City, NY)
- …Social Service Department. + When managed care denies payment for days during concurrent review , contact the attending with this information. The attending can ... needed by the patient and family. **Qualifications** + **Education:** Registered professional nurse licensed to practice in the state of New York + **Experience:**… 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 ... Mail - Sort, identifies location and distribute to appropriate departments + Monitors Concurrent Nurse denial phone calls for UM Nurse to follow +… 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
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