- 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 (Bath, NY)
- …of all duties that may be assigned. EDUCATION: Current New York State Registered Nurse Licensure. BSN preferred. Certification in nursing specialty desirable. ... attends weekly care conference meetings, and weekly Medicare A review with care team and therapies. + Demonstrates effective...of the Long Term Care Department. + Ensures the utilization of the nursing process in maintaining quality of… more
- Arnot Health (Elmira, NY)
- …Auth/Denial Management meetings EDUCATION: RN required. EXPERIENCE: NYS licensed Registered Nurse required. Bachelor's in nursing preferred. Must have ... for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and...proficient writing skills.Experience in Utilization Review and InterQual required. CARDIOPULMONARY RESUSCITATION… more
- Molina Healthcare (Yonkers, NY)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
- Garnet Health (Harris, NY)
- …of care from the hospital to home setting. Responsible for discharge planning, utilization review , team conferences and unit based rounds. At Garnet Health, ... 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
- Stony Brook University (Stony Brook, NY)
- …use of resources. + Oversee staff performance including new staff orientation + Knowledge of Utilization Review and LOS + Review of high-risk complex cases. ... as needed. **Preferred Qualifications:** + Master's Degree, + Certified RN , + CM Five years Case management...or for a maximum of 90 days. An initial review of all applicants will occur two weeks from… more
- Elevance Health (Latham, NY)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… 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
- Ellis Medicine (Schenectady, NY)
- …Workers (SW). The Discharge Planner's primary function is to work with the Social Worker, Nurse Case Manager, or Utilization Management Nurse to ... utilization management activities under the direction of a registered nurse and/or social worker. Responsibilities include...+ Assists Utilization Management with initial clinical review requests as needed. + Notifies Case … more
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