• RN Clinical Manager, Home Health

    CenterWell (Clifton Park, 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...(NY state requirement) + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (05/20/25)
    - Related Jobs
  • UM RN

    Centers Plan for Healthy Living (Queens, NY)
    …various other providers and support involved in the member's care. + Provides utilization review for preauthorization, concurrent and discharge reviews and post ... plans they need for healthy living. JOB SUMMARY: The Utilization Management nurse works within a multidisciplinary...Type of Experience Required: + Active and unrestricted NYS RN license + Minimum 2 years utilization more
    Centers Plan for Healthy Living (04/15/25)
    - Related Jobs
  • Registered Nurse ( RN )…

    Glens Falls Hospital (Glens Falls, NY)
    …30 hours per week, can be found*here*. **Job:** **Nursing - Case Management* **Title:** * Registered Nurse ( RN ) - Care Manager (GFMG) (Flexible Scheduling ... condition that may necessitate treatment change and will attend regular case review meetings. The Care Manager will work closely with the Interdisciplinary Team… more
    Glens Falls Hospital (05/08/25)
    - Related Jobs
  • Clinical Manager Registered Nurse

    Fresenius Medical Center (New York, NY)
    …+ Collaborates closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse manager, the ... + Addressing patient concerns, issues, and questions including the review of patient satisfaction surveys. + Developing and communicating...CQI tools. + Works with the Clinical Coordinator /Charge RN or Nurse Supervisor and Medical Director… more
    Fresenius Medical Center (04/24/25)
    - Related Jobs
  • RN Acute Case Manager - System Care…

    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
    Guthrie (05/13/25)
    - Related Jobs
  • Registered Nurse , Acute Care…

    Bassett Healthcare (Cooperstown, NY)
    …needs. The RN contributes to the support of patients through interdisciplinary teamwork. Registered Nurse I: The RN I status is only appropriate for ... after hire. Salary Range: $36.76 - $55.13 per hour Registered Nurse II: The RN ...as measured by periodic random preceptor and supervisory chart review as per probationary appraisal schedule ( RN more
    Bassett Healthcare (05/14/25)
    - Related Jobs
  • RN Case Manager

    Stony Brook University (Stony Brook, NY)
    …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...other duties as required. **Qualifications** **Required** : Current NYS RN . A Bachelor's degree or a nurse more
    Stony Brook University (04/17/25)
    - Related Jobs
  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Amsterdam, NY)
    …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
    Fresenius Medical Center (05/15/25)
    - Related Jobs
  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Rochester, NY)
    …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
    Fresenius Medical Center (04/16/25)
    - Related Jobs
  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (Syracuse, NY)
    …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
    Molina Healthcare (05/16/25)
    - Related Jobs