- New York State Civil Service (New York, NY)
- …Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review , P26749 Occupational Category Health Care, Human/Social Services ... York State NY Zip Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited to conducting daily … more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... and medical necessity using appropriate criteria, referring those requests that fail review to the medical director for second level review and… more
- CVS Health (Albany, NY)
- …solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible,...experience in Nursing. + At least 1 year of Utilization Management experience in concurrent review or… more
- WMCHealth (Valhalla, NY)
- …of the procedures specified in the Quality Management, Utilization Review and Discharge Planning Program at Westchester Medical Center. Depending ... Asst Utilization Coordinator Company: Westchester Medical Center...of which must have been in the area of utilization review , quality assurance, risk management or… more
- Mount Sinai Health System (New York, NY)
- …State & Federal regulation. + Enters concurrent review information for Review Nurses in Allscripts + Obtains/Prepares Medical Records and other documentation ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...record keeping. Responsible for accurate filing of records, obtaining medical records and mailing of both internal and external… more
- Elevance Health (Latham, NY)
- …prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification ... ** Utilization Management Representative I** **Virtual:** This role enables...responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing… more
- Molina Healthcare (NY)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in… more
- Bassett Healthcare (Cooperstown, NY)
- …enjoy the best quality of life possible. What you'll do The Registered Professional Nurse II, Acute Care is accountable for the delivery of safe patient care ... no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to… more
- Bassett Healthcare (Delhi, NY)
- …enjoy the best quality of life possible. What you'll do The Registered Professional Nurse I, Acute Care is accountable for the delivery of safe patient care ... and job description is only appropriate for a new nurse in the first year of practice, as support...than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title : Nurse Practitioner- Cardiothoracic- Mount Sinai Hospital - Full Time - Night** A nurse practitioner (NP) as described in Title ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more