- BronxCare Health System (Bronx, NY)
- …the department's leadership develop strategies for denial prevention, improved utilization management, documentation of medical necessity and identify patterns and ... completing job tasks. -Assists the Administrative Manager and Director with annual review and revisions of departmental policies, and procedures as required. -When… more
- Bassett Healthcare (Cooperstown, NY)
- …exceptions, as measured by direct supervisory observation and random supervisory chart review + Demonstrates consideration of safety, effective utilization of ... quality of life possible. What you'll do The STAT Nurse RN will provide clinical support and direct patient...than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback +… more
- Albany Medical Center (Albany, NY)
- …policies and procedures, while engaging in and advocating for succession planning for nurse leaders. + Conducts review of appropriate personnel to ensure current ... and manages the administrative, financial and operational responsibilities of fellow Nurse Practitioners and Physician Assistants in the delivery of specialized… more
- University of Rochester (Rochester, NY)
- …application of strict inclusion/exclusion criteria and protocols. Performs meticulous chart review and enters clinical data into the quality databases to identify ... for improved outcomes, reduced cost, improved LOS, and best practice utilization of resources. Performs complete and accurate collection of preoperative, operative,… more
- Nuvance Health (Poughkeepsie, NY)
- …management of patient care to an assigned group of patients through the utilization Standards of Practice and policies and procedures and in collaboration with other ... patient care within the scope of practice as a Nurse (RN or LPN), Respiratory Therapist, EMT, Paramedic. *...forces as requested. * Participates in the discussion and review of articles in the field of hyperbaric oxygen.… more
- Highmark Health (Albany, NY)
- …of the claim rejection and the proper action to complete the retrospective claim review with the goal of proper and timely payment to provider and member ... Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a ...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...patients who were readmitted within thirty days. Documents over utilization of resources and services. + All Medicare cases… more
- Albany Medical Center (Albany, NY)
- …Licensure, Certification & Registration: + Must hold a current NYS Registered Nurse license. Experience: + 7-10 years of experience in nursing, involving ... Responds to changes in work efficiently and effectively. Support implementation and utilization of clinical nursing research. Promote the use by colleges and… more
- Guthrie (Binghamton, NY)
- …leadership and autonomy in nursing practice. + Preferred experience with care management/ utilization review , and payer knowledge. + RN considered. Education: + ... Up to a $15,000.00 Sign on Bonus!! Summary: The Wellness Nurse plays a key role in health promotion and illness prevention of patient populations through… more
- Trinity Health (Albany, NY)
- …Lead - the practice of the profession of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual or potential ... Hospital Admission or specialty consults and obtains records. + Review and reconcile medication list to ensure accurate and...patient know how to contact you, such as a nurse call button. + Thank You- Thank the patient… more