- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- Northwell Health (Poughkeepsie, NY)
- …five (5) years of job entry date + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as ... Responsibilities: + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria… more
- Cognizant (Albany, NY)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- Northwell Health (Syosset, NY)
- …five (5) years of job entry date. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as ... weekdays_ + Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria.… more
- CDPHP (Latham, NY)
- …on nationally recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York State license required. ... to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the...years of acute care experience is required as a Registered Nurse . + Minimum of two (2)… more
- Rochester Regional Health (Rochester, NY)
- …BLS - Basic Life Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... SUMMARY As a Registered Nurse - Care Manager, your...at the most appropriate level; actively participate in the concurrent review process and communicate/intervene with third… more
- Guthrie (Binghamton, NY)
- …or, 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 ... of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who...an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or… more
- Northwell Health (Forest Hills, NY)
- …Degree, preferred.Current license to practice as a Registered Professional Nurse in New York State.Patient Review Instruments (PRI) Certification, preferred. ... in Case Management, preferred.Minimum five (5) years clinical experience as a registered nurse . Prior experience in utilization management and/or discharge… more
- Catholic Health Services (West Islip, NY)
- …degree required. + Master of Science degree strongly preferred. + Licensure: New York Registered Nurse ( RN ) License & Registration. + Certification: Care ... Conditions of Participation. + Implements care management programs, including utilization review , intake and discharge planning. + Evaluates patient care data to… 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 ... **Job Description** ** RN /Case Manager MSH Case Management FT Days** The...experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager… more