- BronxCare Health System (Bronx, NY)
- Overview Licensed Practical Nurse : Under the direct supervision of a physician and/ or Registered Nurse , participates in the application of the nursing process ... collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement… more
- CP Unlimited (Carmel, NY)
- Registered Nurse Type of Position Full time Search Location(s) Carmel, NY, Fishkill, NY, Garrison, NY, Poughkeepsie, NY, Yonkers, NY Apply Now ... (https://phe.tbe.taleo.net/phe03/ats/careers/v2/applyRequisition?org=CPOFNYS&cws=45&rid=6353) Job Brief The Registered Nurse shall provide health related services to individuals who… more
- Constructive Partnerships Unlimited (Staten Island, NY)
- Charge Nurse Type of Position Full time Search Location(s) Staten Island, NY Apply Now ... health care plan by the nursing staff. + In collaboration with Nurse Administrator and VP of Nursing establishes systems for day-to-day medical/nursing operations.… more
- Molina Healthcare (Albany, NY)
- …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases ... of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of… more
- Community Medical and Dental Care Inc (Monsey, NY)
- …Medical and Dental Care, is seeking an experienced Family, Pediatric, or Specialty, Nurse Practitioner. for a full-time or part-time position. We offer a very ... all professional services rendered. + Prepare and review reports, claims , and correspondences. Ensure that records and documentation are...Previous experience of at least 2 years as a Nurse Practitioner. + Ability to establish a healthy rapport… more
- Elevance Health (Latham, NY)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the… more
- Elevance Health (Latham, NY)
- ** Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... an accommodation is granted as required by law._ The ** Nurse Case Manager II** will be responsible for care...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Centene Corporation (New York, NY)
- …a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all outpatient and ... DRG, HCPC reimbursement methodologies. + Documents rate negotiation accurately for proper claims adjudication. + Acts as liaison between the TRICARE beneficiary and… more
- FlexStaff (Poughkeepsie, NY)
- …learning in the timeframe assigned REQUIREMENTS: 1. Maintain current NYS Registered Nurse license - Graduation from an accredited nursing program - Bachelor's Degree ... the code of business conduct, the NYS and federal False Claims Act, whistleblower protection, and mandatory reporting. Complete corporate compliance training… more
- Travelers Insurance Company (Melville, NY)
- …internal and/or external resources for specific activities required to effectively evaluate claims , such as Subrogation, Risk Control, nurse consultants nurse ... evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims . Provides quality claim handling throughout the claim life cycle… more