- Cognizant (Albany, NY)
- …and retro-authorization as well as timely filing deadlines and processes. + Review clinical denials including but not limited to referral, preauthorization, ... determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with...have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical … more
- Catholic Health (Kenmore, NY)
- … to patients and families in the hospital setting. Utilizing foundational nursing clinical skills Utilization Review nurse collaborates with the ... Rotation Hours: 8 am- 4 pm Summary: The Registered Nurse (RN), Utilization Review , as an active... Activities. This includes, but is not limited to, concurrent review , responding to inquiries, complaints, and… more
- UHS (Johnson City, NY)
- …registry by working closely with the TPM and Trauma Registrars to assure accurate, concurrent clinical data abstraction and entry into the trauma registry. The ... Position OverviewThe Trauma Resource Nurse (TRN) has responsibility for concurrent ...to assure the provision of safe, efficient and effective clinical care to all injured patient by continuously monitoring,… more
- Albany Medical Center (Albany, NY)
- …environment. + Basic knowledge of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or ... management to coordinate the appropriate use of resources to achieve maximum clinical and financial outcomes. The Case Manager participates in maintaining quality… more
- Rochester Regional Health (Rochester, NY)
- …necessary and delivered at the most appropriate level; actively participate in the concurrent review process and communicate/intervene with third party payors to ... a holiday every other year. Sign-On Bonus: Yes SUMMARY:As a Registered Nurse - Care Manager, your excellent interpersonal, leadership and collaboration skills ensure… more
- WMCHealth (Valhalla, NY)
- Nurse , Performance Improvement Trauma Coordinator Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Nursing/Nursing Management ... and works closely with the Trauma Registry to ensure accurate concurrent data collection and identification of performance improvement occurrences. The Performance… more
- Northwell Health (Sleepy Hollow, NY)
- …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. ... collaboration with the health care team. + Conducts chart review for appropriateness of admission and continued length of...and continued length of stay; Facilitates throughput. + Conducts clinical reviews and interacts with third party payers to… more
- Northwell Health (Lake Success, NY)
- … clinical documentation in the patient's medical record through a concurrent review process throughout the patient's inpatient stay. 4.Requests clarification ... of clinical documentation from the physician(s) on a ...date. *Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications… more
- Kaleida Health (Buffalo, NY)
- …coding team, Nursing, Patient Management, Quality Department and ancillary staff to perform concurrent analytical review of clinical documentation and coding ... care team. The CDS is also responsible for audit review to identify potential documentation deficiencies in specific records...acute care, medical/surgical or ICU/ED as a licensed Registered Nurse required. 1 year of experience in Clinical… more
- Kaleida Health (Buffalo, NY)
- …coding team, Nursing, Patient Management, Quality Department and ancillary staff to perform concurrent analytical review of clinical documentation and coding ... require leadership abilities.** **Education And Credentials** Bachelors degree required. Registered Nurse required. Cert. Clinical Doc Specialist (CCS) required… more