- 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
- MVP Health Care (Tarrytown, NY)
- …Master's prepared and licensed mental health clinician (LMSW, LCSW, LMHC, etc.) or Licensed Registered Nurse ( RN ) required + New York State license required ... with at least 2 years being ASD related + Utilization or Case Management experience in a managed care...our customers in every interaction **Your key responsibilities:** + Review all requests for behavioral health services utilizing the… more
- Highmark Health (Albany, NY)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
- Sharecare (Albany, NY)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- MVP Health Care (Tarrytown, NY)
- …York** **Qualifications you'll bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 ... **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes assessment, planning,… more
- Constructive Partnerships Unlimited (Brooklyn, NY)
- …communication on medical issues with VP of Nursing, Nurse Administrator, Registered Nurse ( RN ), and Medical Coordinators2. Maintains medical records, ... POSITION SUMMARY Under the Supervision of the VP of Nursing and Nurse Administrators, works collaboratively and assists in the management of medical care… 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
- BronxCare Health System (Bronx, NY)
- …response by the department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal ... the department's leadership develop strategies for denial prevention, improved utilization management, documentation of medical necessity and identify patterns and… more
- Albany Medical Center (Albany, NY)
- …or related field. Licensure, Certification & Registration: + Must hold a current NYS Registered Nurse license. Experience: + 7-10 years of experience in nursing, ... Responds to changes in work efficiently and effectively. Support implementation and utilization of clinical nursing research. Promote the use by colleges and… more
- UHS (Vestal, NY)
- …expert training License/Certification Minimum Required: + Current New York State license as a Registered Nurse + CPR within 3 months of hire Preferred: + ... the highest standards of patient care through effective resource coordination and utilization . In this role, you'll collaborate with clinical teams to manage… more