• Utilization Management Nurse

    CenterWell (Albany, NY)
    …and the healthcare industry as a whole. 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...skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain… more
    CenterWell (08/02/25)
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  • Hospital Concurrent Coding Specialist

    Intermountain Health (Albany, NY)
    …and collaborates with Clinical Documentation Integrity (CDI) Registered Nurses ( RN ) and Intermountain Physician Advisors to review complex facility ... optimization of reviews while patients are hospitalized. It aids in the review of quality measures including Patient Safety Indicators and Hospital Acquired… more
    Intermountain Health (08/08/25)
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  • Hospice Team Manager

    Calvary Hospital (Bronx, NY)
    …overall on-boarding process for patients admitted onto hospice program. + Review /verify admission information- data + Managers team for designated territories, ... including, RN 's LPN's Social Workers, Clerical Staff, Etc. + Ensure...documentation needs + Ensure visit schedule is generated + Review referral information; identify resources necessary for patient admission… more
    Calvary Hospital (06/18/25)
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  • Clinical Regulatory Readiness Manager

    Saratoga Hospital (Saratoga Springs, NY)
    …federal and accreditation requirements, including but not limited to the Centers for Medicare and Medicaid (CMS) and the Joint Commission (JC), DNV, OSHA, CMS and ... survey coordination, offsite mock surveys, unannounced surveys and assists with the review of regulatory standard crosswalks for every dept. in the organization as… more
    Saratoga Hospital (06/28/25)
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  • MDS Assessor

    Stony Brook University (Stony Brook, NY)
    …supporting documentation to support RUG levels claimed. + Collaborate with Nurse Managers to ensure appropriate completion of the resident center comprehensive ... for submission to the Department of Veteran's Affairs. + Completes notification to Medicare beneficiaries for changes in level of care (SNF ABN, NOMNC). + Completes… more
    Stony Brook University (08/14/25)
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  • Managed Care Coordinator

    Elderwood (Waverly, NY)
    …of Medicare and Medicaid Managed Care Policies and Utilization Review . Managed Care Coordinator Skills and Competencies + Demonstrated proficiency with Microsoft ... Overview Mon-Fri 8am-4pm The Managed Care Coordinator assists and supports the LPN/ RN MDS Coordinator with case management responsibilities. The candidate is the… more
    Elderwood (08/11/25)
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  • Patient Care Technician - PCT - Dialysis Preceptor

    Fresenius Medical Center (Syracuse, NY)
    …effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies procedures and training and in compliance ... support to applicable clinical and facility staff. Education/Communication: + Partners with RN and IDT staff to educate the appropriate personnel regarding the… more
    Fresenius Medical Center (07/25/25)
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  • CFSS - Clinical Field Staff Supervisor

    HCR Home Care (Rochester, NY)
    …software. Notify staff , as appropriate , to ensure proper coordination of care. + Review and approve all interim orders before they are sent to physician. Notif y ... is unable to retrieve the unsigned order . + Review and follow-up on entitlement verification issues . +...in nursing preferred. Qualifications and Requirements + Current, valid RN license, issued by NYS Department of Education required… more
    HCR Home Care (08/16/25)
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  • Case Management Assistant

    WMCHealth (Valhalla, NY)
    …computer skills. Responsibilities: + Facilitate discharge planning referrals as guided by RN CM and SW across multiple units + Provide patient/family with ... any updates or completions notes for all referrals + Review worklist for new referrals throughout the day to...preferred + Knowledge of regulatory agency standards; Centers for Medicare & Medicaid Services, and Det Norske Veritas (DNV)… more
    WMCHealth (08/02/25)
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  • Care Manager, Telephonic Nurse

    CenterWell (Albany, NY)
    …off-days during the week.** The **Clinical Care Coordinator/Care Manager, Telephonic Nurse ** helps to ensure optimal continuity of care for patients transitioning ... and under established performance criteria. This is a work-from-home telephonic nurse position **Essential Functions:** + Act as CenterWell Home Health… more
    CenterWell (08/16/25)
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