- Mount Sinai Health System (New York, NY)
- …Additional Detail** 1. Licensure: New York State License with current registration as a registered nurse . 2. 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...follows: a. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
- Molina Healthcare (NY)
- …License, Certification, Association** + Active, unrestricted State Registered Nursing ( RN ) license in good standing. + Utilization Management Certification ... state health plan's Healthcare Services (clinical operations) teams including Utilization Management (prior-authorization, inpatient review ) and Care Management… more
- Evolent (Albany, NY)
- … Nurse + Associate or Bachelors in Nursing (Must be a Registered Nurse ) + Experience as an RN in a Pain Management setting is preferred + Strong ... You'll Be Doing:** Job description: As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way… more
- Mount Sinai Health System (New York, NY)
- …emergencies and supporting patient-centered care. **Qualifications** ? Must be a Licensed Registered Nurse , Physician Assistant or Nurse Practitioner ... of Patient Flow experience preferred 5. EPIC experience preferred. Registered Nurse Licensed NYS Registered ...8 hospitals and over 95 inpatient units. Promotes optimum utilization of system hospital beds by conducting rounds and… more
- AON (New York, NY)
- …years of experience as an accredited claims professional, additional credentials such as a registered nurse or 5 or more years in the safety/risk management in ... services rendered by carriers and/or TPAs to include the review and revision of account instructions, addressing client service...an accredited claims professional, additional credentials such as a registered nurse or 5 or more years… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …peer-to-peer calls in timely manner and provides support for the Case Management (CM) and Registered Nurse ( RN ) reviewers and manages the denial process. + ... management rounds. + Provision of clinical oversight and leadership to Utilization Management/Case Management (UM/CM) staff working with the children's population. +… more
- City of New York (New York, NY)
- …requirement above, candidates must have three years of full-time satisfactory experience as a Registered Nurse , two of which must have been in a supervisory ... with the referring agency and the client's caseworker. 2. Review all available clinically relevant material, including referral information,...have three years of full-time satisfactory experience as a Registered Nurse , one of which must have… more
- WMCHealth (West Nyack, NY)
- …national care management standards and community resources highly preferred. Education: Registered Nurse , Bachelor's degree preferred Licenses / Certifications : ... performed by the Care Manager through extensive medical record review , face to face and/or telephonic encounters with assigned...Current license as a Registered Nurse is required. About Us: Bon… more
- The Institute for Family Health (Bronx, NY)
- …Must have at least one of the listed licensures/certifications: Current NY State Registered Nurse ( RN ) or Certified Dietitian/Nutritionist (CDN) or Current ... and home needs). Adjust intensity of service based on needs, and appropriate utilization of resources. + Develop patient centered plan of care based on… more
- Nuvance Health (Poughkeepsie, NY)
- …license or certification in the respective field of qualifying credential (eg, Registered Nurse , LPN, Respiratory Therapist, EMT or Paramedic) * Maintenance ... care to an assigned group of patients through the utilization Standards of Practice and policies and procedures and...patient care within the scope of practice as a Nurse ( RN or LPN), Respiratory Therapist, EMT,… more