- Evolent (Albany, NY)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
- Albany Medical Center (Albany, NY)
- …study mediation to the patient or set up/schedulemedication infusions or coordinate with nurse to administer study medication injection. 16. Review oral study ... Diem (United States of America) Salary Range: $78,773.63 - $122,099.12 The clinical research coordinator is responsible for the organization and management of… more
- Cognizant (Albany, NY)
- …necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and ... as well as timely filing deadlines and processes. + Review clinical denials including but not limited...thinking skills to interpret guidelines of internal policies for clinical determination. + Medical Necessity Reviews can… more
- Dartmouth Health (Bennington, VT)
- …care, regulatory compliance, clinical staff professional development and peer review . * Collaborates with medical providers, patients & families, community ... care continuum. * Navigates the continuum of care by serving as a clinical resource, assisting with access issues, coordinating transitions with providers and the… more
- Albany Medical Center (Albany, NY)
- …and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and contacts ... improvement in both areas.* Refers cases and issues to Medical Director and Triad Team in compliance with Department...payor criteria and issues and a case-by-case basis with clinical staff and follows up to resolve problems with… more
- CDPHP (Latham, NY)
- …The Utilization Review (UR) Nurse is responsible for the clinical review and documentation for services requiring prior authorization. This includes ... Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… 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
- Albany Medical Center (Albany, NY)
- …$0.00 - $0.00 Position Summary We are seeking a dedicated and compassionate Nurse Practitioner (NP) to join our academic home-based primary care practice, serving ... home visits, telehealth support, and the management of chronic and acute medical conditions, with a strong emphasis on geriatric syndromes, care coordination, and… more
- Fresenius Medical Center (Troy, NY)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities The Care Coordinator Registered Nurse (RN) is responsible for providing competent, evidence-based care to patients. Integrates knowledge, skills,… more
- IQVIA (Albany, NY)
- Mobile Nurse Practitioner - Per Diem, In-Home Services **Location:** Various US locations (local travel within designated geographic area) **About the Role:** ... IQVIA's In-Home Clinical Solutions team seeks a qualified and dedicated Mobile Nurse Practitioner to support patient care by delivering in-home diagnostic… more
- Trinity Health (Albany, NY)
- …Cardiology Office - Albany, NY - FT - Days** If you are looking for a Clinical Nurse Manager position in an Outpatient Cardiology practice, this could be your ... allowance and career development **What you will do:** The Nurse Manager of Clinical Care is directly...ACLS certification + Minimum of ten years demonstrated professional clinical leadership. + Significant electronic medical record… more
- Fallon Health (Berkshire, MA)
- …Information (CORI) results and reliable transportation **Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members ... the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge,… more
- Trinity Health (Albany, NY)
- …Brings patient to exam room, takes appropriate vital signs and documents in electronic medical record. + Review and update medication list to ensure accurate and ... **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Nurse - RNII -Cardiology Office - Phone Triage...complete list in electronic medical record (EMR) available for provider review … more
- Trinity Health (Albany, NY)
- …Brings patient to exam room, takes appropriate vital signs and documents in electronic medical record. Review and update medication list to ensure accurate and ... Type:** Full time **Shift:** Day Shift **Description:** **Senior Registered Nurse - Outpatient Radiation Oncology - St. Peter's Hospital...complete list in electronic medical record (EMR) available for provider review … more
- CenterWell (Albany, NY)
- …complaints. + Makes clinical level of care determination based on discussion, medical records, and any other pertinent clinical data. Matches these needs to ... to work every other holiday.** The **Care Manager, Telephonic Nurse ** helps to ensure optimal continuity of care for...Health, Hospice, and Palliative Care Services. + Assist with clinical eligibility review for alternate services +… more
- Elevance Health (Latham, NY)
- ** Nurse Appeals - Litigation & Legal Support** **In...executive leadership by managing State Fair Hearing and External Medical Review requests. + Acts as a ... necessary and is dependent on court hearing schedules. The ** Nurse Appeals - Litigation & Legal Support** is responsible...accurate entry, investigation, and analysis of state appeals; summarizing medical information for review by medical… more
- Datavant (Albany, NY)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …and record relevant] patient information. Completed work [should need] only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- Elevance Health (Latham, NY)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management...management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of… more