- New York State Civil Service (Bronx, NY)
- …all requirements of non-competitive promotion are met.Promotional Field consists of Registered Nurse 1 Psychiatric (including all language parenthetic) ... in a health care facility regulated by Centers for Medicare and Medicaid Services Utilization Review Standards, or* Possession of a license and registration to… more
- CenterWell (Clifton Park, NY)
- …of Nursing. + BSN required (NY state requirement) + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... on-site at our** **Clifton Park, NY** **branch location.** The ** RN Clinical Manager** coordinates and oversees all direct care...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... All Levels + Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist licensure required; or LMSW;… more
- Molina Healthcare (Buffalo, NY)
- …* UAS experience * Experience conducting home visits Required Licensure or Certification: * Registered Nurse ( RN ) State Specific Requirements: * Must reside ... of CHA paperwork and tasking tool documentation based on review and feedback provided through quality and associated ...or disabled people who are eligible for Medicaid and Medicare . We are looking for a RN … more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …and as directed by their supervisor and Administrator MDS Coordinator Qualifications: + Registered Nurse with current, active license in state of practice. + ... MDS Coordinator RN The Glengariff Healthcare Center is looking for...understanding of MDS requirements related to varied payers including Medicare , Managed Care and Medicaid + Ensures timely electronic… more
- Stony Brook University (Stony Brook, NY)
- …coverage as needed and other duties as required. **Qualifications** **Required** : Current NYS RN . A Bachelor's degree or a nurse working on their degree with ... RN Case Manager **Position Summary** At Stony Brook...following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes… more
- Molina Healthcare (Syracuse, NY)
- …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied ... these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Albany, NY)
- …care experience. **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted State Registered Nursing ( RN ) license in good standing. **PREFERRED ... care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU… more
- HCR Home Care (Plattsburgh, NY)
- …software. Notify staff, as appropriate, to ensure proper coordination of care. + Review and approve all interim orders before they are sent to physician. Notify ... Report when the MRS is unable to retrieve the unsigned order. + Review and follow-up on entitlement verification issues. + Verify/Ensure there are orders for… more
- Healthfirst (NY)
- …request to determine service needsor any necessary adjustments + Review previous nursing assessments/medical notes to determine necessary adjustments/updates in ... duties as assigned **Minimum Qualifications:** + New York State RN license + Ability to travel in and around...(PHI) database experience + Knowledge of health insurance, Medicaid, Medicare and MLTCP + Experience working with a frail… more