- Molina Healthcare (Yonkers, NY)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Molina Healthcare (Yonkers, 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
- Crouse Hospital (Syracuse, NY)
- …requirements and contractual agreements. Manager, Care Coordination Requirements: + Licensed as a Registered Nurse in New York State + Bachelor's degree + Five ... responsible for providing day to day management of the RN Care Managers in the department, including Utilization...acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical,… more
- CVS Health (Albany, NY)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) 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
- New York State Civil Service (Orangeburg, NY)
- …Rockland Children's Psychiatric Center (RCPC) is looking to hire a Registered Nurse 1, Psychiatric, to serve as a Utilization Review Coordinator ... NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 1 Psychiatric, (NY HELPS), Rockland...Proficiency in Microsoft Excel is preferred. URCs at RCPC review electronic and paper clinical medical records for inpatient… 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
- Catholic Health (Buffalo, NY)
- …(2) years acute care RN experience required + Preferred prior insurance /managed care/ utilization review experience in the role of a Case Manager or Disease ... Rotation Hours: 7:30am to 5:30pm/8:00am to 6:00pm Summary: The RN Care Manager, Transition of Care, as an active...BS Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York… more
- Catholic Health (Kenmore, NY)
- …and Holiday Rotation Hours: 0800-1600 with rotation to 0900-1700, 1000-1800. 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
- 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. ... **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
- 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. + ... or a minimum of 3-5 years? experience as a RN in an acute care setting. + Current NYS...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more