- Rochester Regional Health (Rochester, NY)
- …class as needed. Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act as a resource on ... Job Title: Registered Nurse IDepartment: Utilization Management ...medical necessity denials. Review patient class in the event manager , assist with LOC determination retrospectively, and changes patient… more
- CenterWell (Albany, NY)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- CenterWell (Albany, NY)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a...for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the… more
- Arnot Health (Elmira, NY)
- … of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case Manager 's average ... of self and other case managers. f. The Case Manager tracks and trends LOS, resource utilization ,...as a registered nurse . BSN or Case Management Certification preferred. EXPERIENCE: Three years clinical nursing… more
- Elevance Health (Latham, NY)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Rochester Regional Health (Rochester, NY)
- …Week: 40Schedule: M-F Days, with flexibility to work night/off shift SUMMARY:The Assistant Nurse Manager (ANM) is responsible for the clinical care to patients ... ANM is the main contact for a variety of nursing functions in support of management and...resolve patient or family concerns in collaboration with the Nurse Manager /Director; promote optimal care through internal… more
- Mount Sinai Health System (New York, NY)
- …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...(IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of… more
- Rochester Regional Health (Rochester, NY)
- …and direct oversight of day-to-day responsibilities of nursing team members. The Assistant Nurse Manager is the main contact for a variety of nursing ... M-F- 7-330pm, 8-430pm, or rotating with evening hoursSUMMARY:The Assistant Nurse Manager is responsible for the clinical...within practice areao Completes at least one clinical research utilization (CRU) form for submission to Nursing … more
- Rochester Regional Health (Rochester, NY)
- …nursing personnel, physicians and providers*In collaboration with the Nurse Manager /Director, investigates and resolves patient/family/significant other ... Job Title: Assistant Nurse Manager Department: SSDU Location: RGH...ANM is the main contact for a variety of nursing functions in support of management and… more
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