- Rochester Regional Health (Rochester, NY)
- …Certified Home Health Agency (CHHA) clients under the direction of a Registered Nurse and in compliance with Medicare , Medicaid, and NYS Department of Health ... signs and symptoms, and reporting health status changes to the supervising Registered Nurse . + Accurately completes timely documentation in accordance with… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …peer-to-peer calls in timely manner and provides support for the Case Management (CM) and Registered Nurse ( RN ) reviewers and manages the denial process. + ... the UM/ CM staff. + Participates in clinical peer review recruitment and supervision. + Collaborates with Provider Relations...without restrictions and free of sanctions from Medicaid or Medicare required. + Minimum of five (5) years of… more
- Option Care Health (New Rochelle, NY)
- …reviews, discipline, etc.) No Yes X **Basic Education and/or Experience Requirements** + Registered Nurse with a license in the current state of practice ... direct patient care 20-40% of the time. In a Medicare Certified Home Health agency, this position may also...reporting nursing operational and financial data to the Regional Nurse Manager, Area Director of Nursing, and/or Director of… more
- Arnot Health (Elmira, NY)
- …an approved registered nursing program with a current license as a registered nurse . BSN or Case Management Certification preferred. EXPERIENCE: Three years ... the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge...and stay in accordance with Interqual. ** 2. Prepares Medicare /Non Medicare hospital notices of noncoverage (HINN)… more
- Trinity Health (Albany, NY)
- …degree is strongly preferred). Master's degree preferred. Certification (CPHRM) is preferred. Registered Nurse preferred. Ideally, the candidate will have 3-5 ... for the overall patient safety and clinical risk management functions related to review and response to reported events. Responds to crisis situations that have… more
- New York State Civil Service (NY)
- …and procedures when needed to ensure the provision of quality care. * Review of lab work, specialty consults, hospital discharges, medical visit summaries and ... diagnostic reported when needed to assist the group home RN and treatment team to provide the best care...home, the hospital, the rehabilitation setting and/or community providers.* Review and approval of discharge summaries prior to accepting… more
- MVP Health Care (Tarrytown, NY)
- …York** **Qualifications you'll bring:** + Current New York State Licensure as a Registered Nurse is required. + Case Management Certification preferred (ANCC or ... delivery system, including but not limited to Medicaid and Medicare benefits. + The overall objective is to create...care. + The Case Manager will also monitor and review cases with the Medical Director to ensure appropriate… more
- Fresenius Medical Center (Centereach, NY)
- …appointments + Weigh patient and obtain vital signs + Collect treatment records and review for completion. Notify RN of incomplete / missing records. + Cleaning ... effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies procedures and training and in compliance… more
- Ellis Medicine (Schenectady, NY)
- …Level of Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending physician for additional information if ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for case management...Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and… more
- CenterWell (Albany, NY)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...on excellent service to others. **Required Qualifications** + Active RN license + Possession of or ability to obtain… more