- 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
- 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
- CDPHP (Albany, 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
- 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
- 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. ... patient in collaboration with the health care team. + Conducts chart review for appropriateness of admission and continued length of stay; Facilitates throughput.… 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
- 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… 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. 3. Provides clinical information requested ... preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a… more