- 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 ... care management rounds. + Provision of clinical oversight and leadership to Utilization Management/ Case Management (UM/CM) staff working with the children's… more
- CenterLight Health System (Ridgewood, NY)
- …unrestricted license and registration in New York State required as a Registered Nurse . Language: Bilingual preferred. Physical Requirements Individuals must be ... religious backgrounds, and congenital or acquired disabilities. JOB RESPONSIBILITIES: + Review and ensure effective development and execution of personalized care… more
- WMCHealth (West Nyack, NY)
- …national care management standards and community resources highly preferred. Education: Registered Nurse , Bachelor's degree preferred Licenses / Certifications : ... performed by the Care Manager through extensive medical record review , face to face and/or telephonic encounters with assigned...Current license as a Registered Nurse is required. About Us: Bon… more
- CenterLight Health System (Ridgewood, NY)
- …in care/ case management, disease management, population health management, utilization review , quality assurance, or discharge planning (preferably within ... management systems License: Current active and unrestricted license in NYS as a Registered Nurse , required. Additional Requirements: + Be legally authorized (for… more
- FlexStaff (New York, NY)
- …in care/ case management, disease management, population health management, utilization review , quality assurance, or discharge planning (preferably within ... systems License: Current active and unrestricted license in NYS as a Registered Nurse , required. Additional Requirements: Be legally authorized (for example,… more
- Stony Brook University (Stony Brook, NY)
- …Documents the case management plans such as clinical needs, barriers, utilization of resources via assessments and/or progress notes. * Help connect the patient ... may be at a high risk for readmission. The RN following these patients must have good clinical and...to care * Prior experience with Care Management or Utilization Management * Understand levels of care including Inpatient,… more
- Northwell Health (Mount Kisco, NY)
- …Job Description Directs, plans, implements and evaluates all activities of the inpatient RN Case Management and Social Work Services team. Develops processes to ... monitor utilization review inclusive of length of stay...safe discharge back to the community. Job Responsibility 1.Leads RN case management and social work services… more
- Mohawk Valley Health System (Utica, NY)
- …visits. + Gathers data and reports significant change in patient's condition to Registered Nurse or Supervisor as appropriate promptly. + Instructs patients and ... of supportive and restorative care as directed by the Registered Professional Nurse . Core Job Responsibilities +...in appropriate agency meetings and the quality improvement and utilization review activities of the organization. +… more
- Elderwood (Waverly, NY)
- …Companies + Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review . Managed Care Coordinator Skills and Competencies + Demonstrated ... Overview Mon-Fri 8am-4pm The Managed Care Coordinator assists and supports the LPN/ RN MDS Coordinator with case management responsibilities. The candidate is… more
- CVS Health (Albany, NY)
- …visit, inpatient, skilled nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN , the TOC Coach ensures the member experiences a ... or changes in condition to be transitioned back to RN . - Complete post discharge call and required assessments...who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current… more