- CDPHP (Albany, 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)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review ... and competent manner. Processes all prior authorizations to completion utilizing appropriate review criteria. Identifies and refers all potential quality issues… 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
- 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
- Veterans Affairs, Veterans Health Administration (Bronx, NY)
- …apply. Responsibilities The James J. Peters VA Medical Center is recruiting for 1 Quality Management Registered Nurse for the Renal Transplant Program. At the ... the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible...include but are not limited to the following: The Quality Management (QM) Registered Nurse (RN) demonstrates… more
- Molina Healthcare (NY)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical… more
- UHS (Binghamton, NY)
- Position OverviewUnited Health Services (UHS) is seeking a Quality Management Nurse Analyst to support our commitment to excellence in patient care and safety. ... In this analytical and clinically focused role, you will review clinical data, monitor quality metrics, and...role, you will review clinical data, monitor quality metrics, and identify trends to support performance improvement… more
- Bassett Healthcare (Cobleskill, NY)
- …we serve, and our communities, achieve optimum health and enjoy the best quality of life possible. About the department Cobleskill Regional Hospital is a small ... Nurses, and Patient Care Technicians to provide safe and quality patient care in this fast-pace and collegial work...in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Emergency Department is… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title : Nurse Practitioner- Cardiothoracic- Mount Sinai Hospital - Full Time - Night** A nurse practitioner (NP) as described in Title ... 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
- Mount Sinai Health System (New York, NY)
- **Job Description** The Clinical Nurse is a Registered Professional Nurse who provides safe, competent quality care based on nursing theory and research to a ... process and its application + Licensed as a registered nurse with current registration in New York State +...Care, 5 Minute Sit Down, Purposeful Hourly Rounding, Medication Review , Discharge Wrap Up, and MD/RN Unit Collaboration. 2.… more
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