- Catholic Health Services (West Islip, NY)
- …(BSN) degree required. Master of Science degree strongly preferred. Licensure: New York Registered Nurse ( RN ) License & Registration. Certification: Care ... a hospital care management leadership role is required. Experience in utilization management , working with managed care organizations, and discharge planning… more
- MVP Health Care (Rochester, NY)
- …in New York** **Qualifications you'll bring:** + Current New York State Licensure as a Registered Nurse required with at least 4 years of recent clinical and ... Care Management experience. + Certification in Case Manager (CCM) is...confidentiality. + Ability to make independent decisions regarding resource utilization , and quality of care. + Must demonstrate understanding… more
- Mohawk Valley Health System (Utica, NY)
- …+ 8 years of clinical experience. Previous or current experience working in Quality Management / Utilization Management field. + 5 years of management ... Sr Director Quality Management & Regulatory Affairs - Full Time -...health related field Licensure/Certification Requirements REQUIRED: + Licensed NYS Registered Nurse . + CPHQ certification. Disclaimer Qualified… more
- Oneonta Job Corps (Oneonta, NY)
- …Microsoft Suite (Word, Excel, Outlook, PowerPoint.) Educational Requirements: + State Licensed Registered Nurse . + Three years' experience as a practicing ... in nurses' on-call rotation. + Function as a staff nurse as needed. + Collect data and maintain wellness...as needed. + Collect data and maintain wellness monthly Utilization Reports. + Plan, organize, and control the use… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… more
- Molina Healthcare (Buffalo, NY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Fresenius Medical Center (Jamaica, NY)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Schenectady, NY)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... quality of patient care, as defined by the quality goals, by working with management to ensure that policies and procedures are followed. + Assists with implementing… more
- Fresenius Medical Center (Rochester, NY)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... by working with the Vice President of Quality and other organization management to ensure that organization/ASC policies and procedures are followed. + Responsible… more
- Fresenius Medical Center (Bayside, NY)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more