- 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 (Thiells, 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
- Fresenius Medical Center (North Tonawanda, NY)
- …appointments + Weigh patient and obtain vital signs + Collect treatment records and review for completion. Notify RN of incomplete / missing records. + Cleaning ... 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
- Healthfirst (NY)
- …faxes, and any additional information required to complete the audit. + Review and investigate appeals and grievances requests to ensure all requests are ... identified, classified, and fully resolved in a compliant manner. + Review clinical documentation for accuracy, completeness identifying any discrepancies or… more
- Guthrie (Binghamton, NY)
- …prevention of patient populations through nursing-patient collaboration and patient education. This nurse performs the Medicare Annual Wellness Visit under the ... to a $15,000.00 Sign on Bonus! Summary: The Wellness Nurse plays a key role in health promotion and...in nursing practice. + Preferred experience with care management/utilization review , and payer knowledge. + RN considered.… more
- Elderwood (Cheektowaga, NY)
- …of Medicare and Medicaid Managed Care Policies and Utilization Review . Managed Care Coordinator Skills and Competencies + Demonstrated proficiency with Microsoft ... Care Coordinator Overview The Managed Care Coordinator assists and supports the LPN/ RN MDS Coordinator with case management responsibilities. The candidate is the… more
- WMCHealth (Valhalla, NY)
- …pre-bill and post-bill claim edits involving any type of clinical or coding review or required modifier based on services rendered. + Analyze and maintain WMCHealth ... Network Hospitals CDM's to maximize revenue. + Performs periodic review of codes and works with patient billing regarding bundling and unbundling services as… more
- Kaleida Health (Buffalo, NY)
- …provides reimbursement planning and is responsible for key decision-making related to Medicare , Medicaid, and other Third Party Payors to ensure payment. Provides ... **Education And Credentials** **Associate degree in nursing required, bachelor's preferred. RN license required upon hire.** **Experience** **3 years of Long Term… more
- VNS Health (Manhattan, NY)
- …care. * Collaborates with the interdisciplinary clinical team, under the guidance of an RN , to review clinical reports of providers for relevant patient data. ... needs and provider schedules. * Tracks and ensure compliance with Medicare , Medicaid, and insurance guidelines and regulations regarding home health services.… more