- Molina Healthcare (Albany, NY)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is...Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support… more
- WMCHealth (Valhalla, NY)
- …the procedures specified in the Clinical Care Management Department through review of the Utilization and Discharge Planning Program at Westchester Medical ... (https://pm.healthcaresource.com/cs/wmc1/#/preApply/31222) Internal Applicant link Job Details: N4 Supervisor of Nursing/ Nurse Manager - Clinical Care Management Internal… more
- Rochester Regional Health (Rochester, NY)
- …in the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization , performing continued stay reviews ... efficient utilization of resources. Carries out activities related to utilization management , discharge planning, care coordination and referral to other… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management , care transition, collaboration with physicians ... experience in a hospital environment preferred. + Previous case management , utilization review , and discharge...transition of care with Social Worker + Serves as nurse consultant for Social Worker cases with Clinical or… more
- Mount Sinai Health System (New York, NY)
- …infectious precautions patient populations, constant observation and patient restraints review , risk management activities identifying and communicating issues ... The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse , Physician Assistant, or Nurse Practitioner, who manages the 24… more
- Constructive Partnerships Unlimited (Brooklyn, NY)
- …and Nurse Administrators, works collaboratively and assists in the management of medical care for all individuals served and maintaining appropriate ... various source documents into the computer system for storage, processing and data management purposes. Shift Worked: 9:00 AM-5:00 PM Weekly Hours: 37.5 FLSA Status:… more
- CenterWell (Liverpool, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...and reliable transportation. + Two years as a Registered Nurse with at least one-year of management … more
- Elevance Health (New York, NY)
- …members and providers. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology regimens ... and supportive care. + Perform physician-level case review , following initial nurse review ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- BronxCare Health System (Bronx, NY)
- …assist the department's leadership develop strategies for denial prevention, improved utilization management , documentation of medical necessity and identify ... of stay, avoidable day and barriers to discharge processes pertaining to utilization management . - Liaisons and coordinates with other hospital departments… more
- Villa of Hope (Rochester, NY)
- …coordinator, providers, director of LHTC and administrative team, including billing and utilization review . + Triages potential admissions and when needed ... JOB TITLE: Intake Coordinator- RN/ Evening DEPARTMENT/PROGRAM: Medical Services SUPERVISOR: Nurse Manager/Health Coordinator PAY GRADE: 82 FLSA STATUS: NON EXEMPT… more