- Ellis Medicine (Schenectady, NY)
- …utilization management activities under the direction of a registered nurse and/or social worker. Responsibilities include maintaining case files, updating ... primary function is to work with the Social Worker, Nurse Case Manager, or Utilization Management ...Case Manager with medication prior authorizations. + Provides Medicare Important Message to Medicare beneficiaries per… more
- WMCHealth (Warwick, NY)
- …accredited School of Nursing, BSN Preferred Licensure/Certifications: Valid and current NYS Registered Nurse and MDS AANAC Certification Preferred If applicable, ... Apply Now External Applicant link Internal Applicant link Job Details: The MDS Nurse provides leadership and clinical assistance to all facility personnel to ensure… more
- Centene Corporation (New York, NY)
- …State Licensure required or + LVN - Licensed Vocational Nurse required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... and National Committee for Quality Assurance (NCQA) standards. + Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …calls in timely manner and provides support for the Case Management (CM) and Registered Nurse ( RN ) reviewers and manages the denial process. + Leads ... rounds. + Provision of clinical oversight and leadership to Utilization Management/ Case Management (UM/CM) staff working with the children's population. + Develops,… more
- Project Renewal, Inc. (Bronx, NY)
- …psychiatric services are provided Monday through Friday, staffed by a psychiatrist, nurse practitioner, registered nurse , and a licensed practical ... with mental illness and/or substance abuse. Our comprehensive services include case management, individual and group counseling, recreational activities, and housing… more
- Elderwood (Buffalo, NY)
- …Responsibilities In the role of an Social Work Care Manager, you will partner with the Registered Nurse and are a critical resource for our members as you are ... or caregivers and reports changes in conditions to the RN Care Manager, which may require interventions. + Participate...Work experience with at risk populations in home care, case management, discharge planning or managed care. + Minimum… more
- Trinity Health (Albany, NY)
- …degree is strongly preferred). Master's degree preferred. Certification (CPHRM) is preferred. Registered Nurse preferred. Ideally, the candidate will have 3-5 ... the Department of Health as required by law. **_Specific Activities_** + Conducts case finding by daily review of reported events and other information retrieved… more