- NewYork-Presbyterian (Brooklyn, NY)
- …an average of 60-70 medical/surgical daily admissions that requires risk identification and clinical reviews. A utilization nurse completes no less than 20 ... are listed in the following description. Case Manager - RN - Inpatient Units- Brooklyn Methodist - Days Located...inpatient criteria or continued inpatient stay - Coordinating expedited appeals for inpatient denials with attending physicians… more
- BronxCare Health System (Bronx, NY)
- …by the department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal and ... arrive in letter and electronic format. Collaborating with the Department Denial and Appeals Coordinators, Physician Advisors, and the clinical staff, the Appeal… more
- Mount Sinai Health System (New York, NY)
- …timely and appropriate communication with payers for authorization, denials , and appeals . + Collaborate with physicians and clinical teams to ensure ... (CCM, ACM) or Utilization Management preferred. + 7+ years of experience in clinical acute clinical , utilization management, appeals management or related… more
- 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 ... responsible for providing day to day management of the RN Care Managers in the department. Pay Range: $95,000...in the department, including Utilization Management, Discharge Planning and Denials and Appeals functions. + Assessing workflow… 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
- 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 ... of coverage of ordered medications. + Coordinate and complete appeals for denials as needed + Monitor...offices and for DBL office as needed Coverage for RN Nurse Navigator + Coordinate and facilitate… more
