- Guthrie (Binghamton, NY)
- …services regarding admissions, case management , discharge planning and utilization review . Responsibilites: Reviews admissions and service requests within ... planning needs with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversees and coordinates compliance to… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse IDepartment: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time)Schedule: Monday ... Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act...- Basic Life Support - American Heart Association (AHA), RN - Registered Nurse -… more
- Guthrie (Binghamton, NY)
- …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant...members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria.… more
- Molina Healthcare (Buffalo, NY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing....Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
- Molina Healthcare (Yonkers, NY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing....Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
- Glens Falls Hospital (Glens Falls, NY)
- …per week, can be found*here*. **Job:** **Nursing - Case Management * **Title:** * Registered Nurse ( RN ) - Care Manager (GFMG) (Flexible Scheduling Options ... condition that may necessitate treatment change and will attend regular case review meetings. The Care Manager will work closely with the Interdisciplinary Team… more
- MVP Health Care (Rochester, NY)
- …in New York** **Qualifications you'll bring:** + Current New York State Licensure as a Registered Nurse required with at least 4 years of recent clinical and ... Care Management experience. + Certification in Case Manager (CCM) is...confidentiality. + Ability to make independent decisions regarding resource utilization , and quality of care. + Must demonstrate understanding… more
- Northwell Health (Staten Island, NY)
- …care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness ... license to practice as a Registered Professional Nurse in New York State. + Case Management... and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge… more
- Fresenius Medical Center (Jamaica, NY)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Bayside, NY)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more