- City of New York (New York, NY)
- …required; make professional recommendations accordingly. - Keep abreast of medical and utilization review techniques and developments relative to the nursing ... Nurse in the Bureau of Medical and Professional Review (BMPR) of Home Care Services Program. As the...- 50935 Qualifications 1. A valid New York State Registered Nurse License and completion of one… more
- CVS Health (Albany, NY)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse Case Manager IIDepartment: Home Care Location: West Monroe Hours Per Week: 40Schedule: Days SUMMARY:The RN Case Manager is ... + Practices according to Agency and community standards + Participates in utilization review and/or continuous quality improvement activities as requested. +… more
- Northwell Health (Staten Island, NY)
- …case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. * Keeps ... utilization management using Interqual criteria. * Conducts chart review for appropriateness of admission and continued length of...Nursing, required. * Current license to practice as a Registered Professional Nurse in New York State.… more
- Mount Sinai Health System (New York, NY)
- …Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager ... **Job Description** ** RN /Case Manager MSH Case Management FT Days** The...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
- Catholic Health (Buffalo, NY)
- …and Holiday Rotation Hours: Primary 10-6pm with potential rotation 8-4pm, 9-5pm Summary: The Registered Nurse ( RN ) Care Manager-Transition of Care, as an ... BS Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York...and/or community health nursing + Preferred prior insurance /managed care/ utilization review experience in the role of… more
- Guthrie (Binghamton, NY)
- …or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or ... of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who...in an acute care setting with strong care management, utilization review , and payer knowledge. A Case… more
- Mount Sinai Health System (New York, NY)
- …Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** ** RN /Case Manager (Inpatient) Mount Sinai Morningside FT Days...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
- CenterWell (Westbury, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Cognizant (Albany, NY)
- …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more