- Evolent (Albany, NY)
- …The Specialty Appeal nurses work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators who set up the ... appeal, Physicians and other Clinicians who review the appeal, and managers for direction and leadership....to company policies and procedures. + Documents communications with medical office staff and/or MD provider as required. +… more
- UHS (Johnson City, NY)
- …surgical team and play a vital role in delivering safe, efficient, and high- quality care. In this fast-paced role, you'll prepare operating rooms, ensure surgical ... skills to UHS. Primary Department, Division, or Unit: Operating Room, UHS Wilson Medical Center Primary Work Shift: Day Rotational Regular Scheduled Weekly Hours: 40… more
- BAYADA Home Health Care (West Hempstead, NY)
- …healthcare is best delivered in the comfort of home. We provide the highest quality care to clients with complex medical needs. **Why Nurses Choose BAYADA:** ... supervise field staff , follow up with physicians, note review , and provide hands on care in the field....times to local clients + **Comprehensive Benefits** - PTO, medical , dental, vision, 401(k) + **Career Growth & Development**… more
- City of New York (New York, NY)
- …equity-driven, engaging, and responsive. We're looking for a motivated and mission-aligned Nurse Practitioner Medical Director to help lead that vision. DUTIES ... now available within the Division of Administration, Offices of Clinical Quality Management and Improvement/Employees' Health Program. We're building an Employee… 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 ... Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for… more
- SUNY Upstate Medical University (Syracuse, NY)
- …Patient Relations department with patient complaints that require quality review and/or Risk oversight. Minimum Qualifications: Registered Nurse , NYS License ... conduct internal quality reviews through the institution-defined quality review process. Supports the Attorney General's... process. Supports the Attorney General's office in the review and defense of medical malpractice actions… more
- Molina Healthcare (Yonkers, 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
- Fresenius Medical Center (New York, NY)
- … quality improvement tools and electronic applications. + Performs desk review of facility Quality Assessment and Performance Improvement (QAPI) documentation ... + Registered Nurse required + Certification in Nephrology Nursing or quality preferred. **EXPERIENCE AND SKILLS** : * 3+ years dialysis experience required. *… more
- Mount Sinai Health System (New York, NY)
- …** For Future and Current Opportunities** Mount Sinai Hospital RN Float Pool (ICU and Medical Surgical Step Down) The Clinical Nurse for the Mount Sinai nursing ... float pool is a Registered Professional Nurse who provides safe, competent quality care...Care, 5 Minute Sit Down, Purposeful Hourly Rounding, Medication Review , Discharge Wrap Up, and MD/RN Unit Collaboration. 2.… more
- Molina Healthcare (Syracuse, 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