- Crouse Hospital (Syracuse, NY)
- …requirements and contractual agreements. Care Coordination Manager Requirements: + Licensed as a Registered Nurse in New York State + Bachelor's degree + Five ... Coordination Manager who is responsible for providing day to day management of the RN Care Managers in the department. Pay Range: $95,000 plus based on education and… more
- BronxCare Health System (Bronx, NY)
- …response by the department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal ... Overview The Appeals Manager is responsible to assist in the...tasks. -Assists the Administrative Manager and Director with annual review and revisions of departmental policies, and procedures as… more
- BronxCare Health System (Bronx, NY)
- …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute...submission in appeal. - In absence of Director, will review denial correspondence to determine validity of denial reason… more
- Molina Healthcare (Buffalo, NY)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... Looking for a RN with experience with appeals , claims review , and medical coding. JOB...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Catholic Health Services (West Islip, NY)
- …degree required. + Master of Science degree strongly preferred. + Licensure: New York Registered Nurse ( RN ) License & Registration. + Certification: Care ... not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals , Managed Care and Revenue Cycle and Patient Access departments to ensure… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** RN /Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case management for an assigned ... experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager...or a minimum of 3-5 years experience as a RN in an acute care setting. Licensing and Certification… more
- SUNY Upstate Medical University (Syracuse, NY)
- …preparing regulatory notices for delivery to the patient Minimum Qualifications: NYS Licensed/ Registered (or eligible) RN , Bachelor's Degree in Nursing, and a ... reimbursement entities. This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure...minimum of three years post RN licensure acute care nursing experience, or Associate's Degree… more
- Community Wellness Partners (Oswego, NY)
- …or more than forty (40) hours per week. QUALIFICATIONS: 1. Current NYS Licensed Registered Nurse 2. Knowledge of MDS 3.0, CAA's, Medicare and Medicaid Guidelines ... WAGE RATE - $75K - $85K/Year GENERAL DESCRIPTION: MDS (Minimum Data Set) nurse collects and assesses information for the health and well-being resident in Medicare… more
- Calvary Hospital (Bronx, NY)
- …year Requirements QUALIFICATIONS: 1. Master of Nursing Degree required. 2. NYS unencumbered Registered Nurse License required. 3. Ten (10) to fifteen (15) years ... to facilitate reimbursement for services provided by the Hospital. Oversees the appeals process for those cases for which reimbursement has been denied. Conducts… more
- Guthrie (Binghamton, NY)
- …needed for patient that have arrived without orders. Prepare educational materials for the RN Nurse Navigator for Chemo Education Visits per the instruction and ... appeals for denials as needed + Monitor and Review REMS clearance for monthly refills of high-risk medications...offices and for DBL office as needed Coverage for RN Nurse Navigator + Coordinate and facilitate… more