- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …trends on a monthly basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates in, and attends ... MDS Coordinator RN The Glengariff Healthcare Center is looking for...by their supervisor and Administrator MDS Coordinator Qualifications: + Registered Nurse with current, active license in… more
- Arnot Health (Elmira, NY)
- …of an approved registered nursing program with a current license as a registered nurse . BSN or Case Management Certification preferred. EXPERIENCE: ... management of patient care . The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case Manager's… more
- MVP Health Care (Schenectady, NY)
- …you'll bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months after ... key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that...the coordination of quality cost effective care. + The Case Manager will also monitor and review … more
- MVP Health Care (Rochester, NY)
- …whether the denial should be overturned + Collaborate with MVP Medical Directors, Utilization Management and Case Management to ensure alignment with MVP's ... achieve this, we're looking for a **Professional, Clinical Appeals RN ** to join #TeamMVP. This is the opportunity for...and clinical guidelines. + Previous experience in clinical appeals, utilization management or managed care and LTSS is highly… more
- Garnet Health (Harris, NY)
- …Swing Bed, Acute, and Emergency Department Patients. Responsible for discharge planning, utilization review , team conferences and unit-based rounds. Acts as a ... to make your career home with us as a Case Manager on our Case Management team...negotiated contracts, budget and internal equity). Qualifications Minimum Education: Registered Nurse with New York State Licensure… more
- Nuvance Health (Poughkeepsie, NY)
- …Must have Associate's Degree in Nursing, BSN preferred. Must have current RN license. *Preferred Experience: * Utilization Review /Management.Company: Vassar ... Summary - Discharge Planning primarily Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to… more
- Elevance Health (Latham, NY)
- **Telephonic Transplant Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person ... different states; therefore, Multi-State Licensure will be required.** The **Telephonic Transplant Nurse Case Manager II** is responsible for care management… more
- Rochester Regional Health (Rochester, NY)
- …Support - American Heart Association (AHA)American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education ... the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization ,...required + Licensed in New York State as a Registered Nurse + For hires after 10/28/2024,… more
- Deloitte (New York, NY)
- …as clinical registered nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics ... Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical… more
- Datavant (Albany, NY)
- …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more