- Northwell Health (Staten Island, NY)
- …in case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. ... utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of...Nursing, required. + Current license to practice as a Registered Professional Nurse in New York State.… more
- Northwell Health (Bay Shore, NY)
- …Degree in Nursing or related field, preferred. + Current license to practice as a Registered Professional Nurse in New York State. + Minimum of two (2) years ... to the Hospital. Job Responsibility + * Performs concurrent review on all patients and share all problematic cases...as required. + * Participates in the maintenance of Utilization Management, Discharge Planning and Case Management statistics as… more
- Fresenius Medical Center (Mineola, NY)
- …Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies ... auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic… more
- Veterans Affairs, Veterans Health Administration (Montrose, NY)
- …veteran's home . Responsibilities The Home Based Primary Care (HBPC) HBPC/ SCI/D RN /CM Outpatient Staff Registered Nurse ( RN ) is responsible for ... to collaborate with the core Interdisciplinary team, in a Home Based setting. The RN is responsible...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse Case Manager IIDepartment: Home Care Location: West Monroe Hours Per Week: 40Schedule: Days SUMMARY:The RN Case Manager is ... + Practices according to Agency and community standards + Participates in utilization review and/or continuous quality improvement activities as requested. +… more
- City of New York (New York, NY)
- …and initiative, serves as a Head Nurse in the Bureau of Medical and Professional Review (BMPR) of Home Care Services Program. As the Head Nurse , they ... professional recommendations accordingly. - Keep abreast of medical and utilization review techniques and developments relative to...- 50935 Qualifications 1. A valid New York State Registered Nurse License and completion of one… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State...Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal… more
- Molina Healthcare (Buffalo, NY)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- CenterWell (Albany, NY)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent… more
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