- CDPHP (Latham, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... physician-founded, member-focused, and community-based not-for-profit health plan that offers high- quality affordable health insurance to members throughout New York.… more
- Centene Corporation (New York, NY)
- …setting to determine overall health and appropriate level of care + Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
- Centene Corporation (New York, NY)
- …benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care. + Performs medical necessity ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
- Albany Medical Center (Albany, NY)
- …America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. * Completes ... Utilization Management and Quality Screening for assigned patients.* Applies MCG criteria to monitor appropriateness of admissions and continued stays, and documents… more
- Centene Corporation (New York, NY)
- …benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care. + Performs medical necessity ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
- CVS Health (Albany, NY)
- …And we do it all with heart, each and every day. **Position Summary** The Quality Management Nurse (QM Nurse ) supports Aetna Better Health of Texas ... quality initiatives. This role combines clinical expertise with quality improvement leadership, including clinical documentation review , Performance… more
- City of New York (New York, NY)
- …now available within the Division of Administration, Offices of Clinical Quality Management and Improvement/Employees' Health Program. We're building an Employee ... equity-driven, engaging, and responsive. We're looking for a motivated and mission-aligned Nurse Practitioner Medical Director to help lead that vision. DUTIES WILL… more
- Bassett Healthcare (Cooperstown, NY)
- …we serve, and our communities, achieve optimum health and enjoy the best quality of life possible. About the department Bassett Medical Center's Operating Room / ... OR nurses are critical in delivering safe, efficient, and quality care to patients throughout surgical procedures while collaborating...in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Operating Room /… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title - Nurse Practitioner-Pediatric Cardiology - Mount Sinai Hospital - Full Time - Day** A nurse practitioner (NP) as described in ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion… more
- Bassett Healthcare (Cooperstown, NY)
- …the population we serve, and our communities, achieve optimum health and enjoy the best quality of life possible. What you'll do The Licensed Practical Nurse - ... of the department manager and the clinical direction of the Registered Professional Nurse , Physician or Surgical PA, provides technical and clinical support to the… more