- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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 (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
- 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
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