- 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...by performing advanced level work related to clinical denial management and managing clinical denials from Providers… more
- WMCHealth (Valhalla, NY)
- …2. Identify opportunities to improve reimbursement. 3. Provide direction to the Case Management staff in relation to denials /appeals which includes training and ... insurance and finance into decision making and problem solving regarding denial management . + Explores strategies to reduce Insurance denials , implements them… more
- Datavant (Albany, NY)
- …Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient admission. ... by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing… 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 ... Supports all CH and consultant initiatives addressing activities relative to Care Management and Denials . + Identifies opportunities for improvement that result… more
- Nuvance Health (Poughkeepsie, NY)
- …- Discharge Planning primarily Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support the ... to prevent the denial where possible. 5. Supports the effective prevention and management of denials , including providing information as part of the appeal… more
- Stony Brook University (Stony Brook, NY)
- …communication skills while adhering to our high standard of excellence. **Duties of a RN Case Manager in the Care Management Department may include the following ... assigned. Identifies, follows and documents Avoidable delays in Care Management Program. Reviews and documents on patients who were...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN… more
- BronxCare Health System (Bronx, NY)
- …response by the department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal ... department's leadership develop strategies for denial prevention, improved utilization management , documentation of medical necessity and identify patterns and… more
- Rochester Regional Health (Rochester, NY)
- …Support - American Heart Association (AHA)American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education ... Job Title: Care Facilitator Department: Case Management Location: Canton-Potsdam Hospital with floating to other...required + Licensed in New York State as a Registered Nurse + For hires after 10/28/2024,… more
- BronxCare Health System (Bronx, NY)
- …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... Overview Assists in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care… more
- Rochester Regional Health (Rochester, NY)
- …experience preferred. + Experience with EPIC preferred. EDUCATION: BS LICENSES / CERTIFICATIONS: RN - Registered Nurse - New York State Education ... and performance standards. + Provides direct managerial oversight to CDI Team in management of CDI processes CDI projects, barriers and education work processes, to… more