- 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 ... coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care reviews, post-acute care initial… 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)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review , P26749 ... Zip Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited to conducting daily Utilization … more
- Veterans Affairs, Veterans Health Administration (Bronx, NY)
- …Responsibilities The James J. Peters VA Medical Center is recruiting for 1 Quality Management Registered Nurse for the Renal Transplant Program. At the full ... include but are not limited to the following: The Quality Management (QM) Registered Nurse (RN) demonstrates...The QM RN is assigned responsibility for their assigned quality management program area activities for the Medical… more
- Veterans Affairs, Veterans Health Administration (Buffalo, NY)
- …Western New York VA Medical Center is hiring for a, full-time Registered Nurse to serve as the Surgery Quality Improvement Program Quality Consultant. ... The VA Surgery Quality Improvement Program (VASQIP) Quality Consultant Registered Nurse (RN) demonstrates leadership,...and regulations into the local surgical department and surgical quality review process. The VASQIP Consultant works… 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 ... within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in… 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. +… more
- Bassett Healthcare (Cooperstown, NY)
- …population we serve, and our communities, achieve optimum health and enjoy the best quality of life possible. What you'll do The Registered Professional Nurse ... no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to… more
- Bassett Healthcare (Delhi, NY)
- …population we serve, and our communities, achieve optimum health and enjoy the best quality of life possible. What you'll do The Registered Professional Nurse I, ... and job description is only appropriate for a new nurse in the first year of practice, as support...than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes… more