- 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 connectivity ... (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
- Molina Healthcare (Rochester, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Buffalo, NY)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...the specific programs supported by the plan such as utilization review , medical claims review ,… more
- Molina Healthcare (Albany, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Review Clinician RN provides support for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** *… more
- Molina Healthcare (Rochester, 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
- UHS (Norwich, NY)
- …Health Services (UHS) Chenango Memorial Hospital is seeking a compassionate and skilled Staff Registered Nurse ( RN ) or Graduate Nurse (GN) dedicated ... treatment. You will uphold all professional standards, including the New York State Nurse Practice Act and UHS policies, while fostering a caring and healing… more
- Molina Healthcare (Syracuse, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
- Villa of Hope (Rochester, NY)
- …JOB SUMMARY: Under the general direction of the Nurse Manager, the Intake Coordinator- RN is a Registered Nurse who will assist in supervising Clinical ... director of LHTC and administrative team, including billing and utilization review . + Triages potential admissions and...or leaving against medical advice. MINIMUM QUALIFICATIONS: + NYS Registered Nurse license + Bachelor degree preferred… more
- Mount Sinai Health System (Long Island City, NY)
- …REQUIREMENTS** Licensure: New York State License with current registration as a registered nurse . State Certification: Certified by the New York State ... 6910 of the New York Education Law is a RN who has earned a separate certification as an...as follows: a.Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
- Centene Corporation (New York, NY)
- …flexibility. This is a fully remote position. Applicants must hold an active LPN or RN license in the State of New York to be eligible for consideration. **Position ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
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