- Northwell Health (Forest Hills, NY)
- …Masters Degree, preferred.Current license to practice as a Registered Professional Nurse in New York State.Patient Review Instruments (PRI) Certification ... etc 2. are appropriately arranged for and financially approved.Performs concurrent utilization management.Reviews appropriateness of patient's admission, need for… 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 ... Minimum Required: + Current CPR Certification. + Current provider certification in Trauma Nurse Core Course (TNCC) or Advanced Trauma Care for Nurses (ATCN). +… more
- WMCHealth (Valhalla, NY)
- …and works closely with the Trauma Registry to ensure accurate concurrent data collection and identification of performance improvement occurrences. The Performance ... Medical Director, Trauma Program Manager, Trauma Registrars and other disciplines to review the performance and safety of the Trauma Program including coordinating… 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
- 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
- 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
- Northwell Health (Melville, NY)
- …care decisions and billing status and ensures compliance with the Utilization Review standard and regulations. Performs concurrent and retrospective utilization ... of illness and intensity of services provided. Performs PRI's (Patient Review Instrument), as needed. Performs related duties as required. All responsibilities… more
- Northwell Health (Staten Island, NY)
- …to another level of care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for ... Sheet and the Patient Transfer Sheet. + Ensures Patient Review Instrument (PRI) is completed and reflects clinical profile...+ Current license to practice as a Registered Professional Nurse in New York State. + Case Management Certification,… 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
- 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