- Mount Sinai Health System (New York, NY)
- …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
- Centene Corporation (New York, NY)
- …findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and ... preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN -… more
- Molina Healthcare (NY)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... Experience using PEGA **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… more
- Veterans Affairs, Veterans Health Administration (Bronx, NY)
- …Responsibilities The James J. Peters VA Medical Center is recruiting for 1 Quality Management Registered Nurse for the Renal Transplant Program. At the full ... program include but are not limited to the following: The Quality Management (QM) Registered Nurse (RN) demonstrates leadership, experience, and creative… more
- Sharecare (Albany, NY)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title : Nurse Practitioner- Cardiothoracic- Mount Sinai Hospital - Full Time - Night** A nurse practitioner (NP) as described in Title ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Mount Sinai Health System (Manhattan, NY)
- **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Crouse Hospital (Syracuse, NY)
- …day management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... Manager who is responsible for providing day to day management of the RN Care Managers in the department....acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical,… more
- Catholic Health (Buffalo, NY)
- …Two (2) years acute care RN experience required + Preferred prior insurance /managed care/ utilization review experience in the role of a Case Manager or Disease ... of Care, as an active member of the Care Management and interdisciplinary care team, provides comprehensive case ...Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York State + New… more
- Bassett Healthcare (Cobleskill, NY)
- …enjoy the best quality of life possible. What you'll do The Registered Professional Nurse II, Acute Care is accountable for the delivery of safe patient care ... no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes assessment data to… more