- 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
- Bassett Healthcare (Oneonta, NY)
- …best quality of life possible. What you'll do Working under the supervision of the Nurse Manager of Care Management, the Registered Nurse Care Manager serves in ... patients receive quality, efficient, and cost-effective healthcare services. The Nurse Care Manager assesses, plans, implements, coordinates, monitors, and evaluates… more
- Bassett Healthcare (Cooperstown, NY)
- …continuous improvement in both areas. + Refers cases and issues to Case Review , Utilization Committee, Medical Director, and Director of Quality in compliance with ... and self-pay issues as needed + Interfaces with IPRO and other review agencies regarding denials, retrospective reviews. + Ensures that all elements critical… more
- Guthrie (Corning, NY)
- …a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or BA degree ... 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 related… more
- Kaleida Health (Buffalo, NY)
- …team, Nursing, Patient Management, Quality Department and ancillary staff to perform concurrent analytical review of clinical documentation and coding data.The ... of the health care team. The CDS is also responsible for audit review to identify potential documentation deficiencies in specific records and to identify clinical… more
- Arnot Health (Elmira, NY)
- …qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and retrospective ... with physicians and other Arnot Health departments in matters of auth/denial review decisions. 8. Maintains a working relationship with Physician Advisor regarding… more
- Guthrie (Binghamton, NY)
- …a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or BA degree ... 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 related… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …+ Assess discharge planning needs at the patient's admission + Perform regular concurrent review on all patients and coordinate all needed services including ... and acquire authorizations for treatment **Key Qualifications:** + Current NYS Registered Nurse License/Registration and BSN preferred + At least 2-3 years of… more
- Molina Healthcare (Syracuse, NY)
- …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care ... Public Health, Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review , medical policy/procedure development, provider contracting experience. + Experience… more
- Baylor Scott & White Health (Albany, NY)
- …qualifications and prior experience. **Essential Functions of the Role** + Performs concurrent and retrospective medical record review to investigate quality ... tasks to meet desired deadlines + Licensed clinician such as nurse , physical therapist, occupational therapist, dietitian, respiratory therapist, etc. preferred.… more
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