- Jobleads-US (New York, NY)
- …excellence in patient care and staff support. Requirements Active New York State (NYS) Registered Nurse ( RN ) License. Strong knowledge of Certified Home ... Quality Management RN Brooklyn, NY Monday - Friday 8:30 am...Contribute to continuous performance improvement initiatives. Prepare and manage appeals processes. Track and manage grievances. Analyze patient satisfaction… more
- MVP Health Care (Tarrytown, NY)
- …requires innovative thinking and continuous improvement. To achieve this, we're looking for a ** Professional , Clinical Appeals RN ** to join #TeamMVP. ... in New York.** **Qualifications you'll bring:** + Active, unrestricted RN license in good standing + Graduate of an...and clinical guidelines. + Previous experience in clinical appeals , utilization management or managed care… more
- Centene Corporation (New York, NY)
- …be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... appeals and grievances from a clinical perspective. Ensure that the clinical Appeals and Grievance department processes all cases in accordance with… more
- WMCHealth (Valhalla, NY)
- …or continued stay, when necessary. + Secures physician input for insurance appeals when necessary. + Incorporates knowledge of clinical expertise, quality, ... Denials and Appeals Mngmt Cord Company: WMC Advanced Physician Services...policies and procedures. + Incorporates the highest standard of professional , clinical , legal, and ethical practice (ie,… more
- Molina Healthcare (Buffalo, NY)
- …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review,... resource for utilization management, CMOs, physicians and member/provider inquiries/ appeals . + Provides training and support to clinical… more
- Molina Healthcare (NY)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Rochester, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are… more
- FlexStaff (Brooklyn, NY)
- …excellence in patient care and staff support. Requirements: + Active New York State (NYS) Registered Nurse ( RN ) License. + Strong knowledge of Certified Home ... **Req Number** 169850 Quality Management RN Brooklyn, NY Monday - Friday 8:30 am...to continuous performance improvement initiatives. + Prepare and manage appeals processes. + Track and manage grievances. + Analyze… more
- MVP Health Care (Tarrytown, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a ** Professional , Sub-Acute RN UM Reviewer - Medicare** to join #TeamMVP. If ... you have a passion for patient-centered advocacy, clinical precision and regulatory compliance this is an opportunity...you'll bring:** + Current and unrestricted NY & VT RN licensure + Associate or bachelor's degree in nursing… more
- Albany Medical Center (Albany, NY)
- …on the subject of accurate and ethical E/M coding and documentation. 12. Submitting appeals for clinical validation in compliance with ICD 10 coding guidelines ... of accurate and ethical E/M coding and documentation.12. Submitting appeals for clinical validation in compliance with...obtained within the first two years of employment + RN license preferred + Advanced clinical experience… more
