- FlexStaff (Uniondale, NY)
- …Under the direction of the Senior Director of Clinical Review , the Clinical Review Nurse is responsible for complying with the day-to-day operations ... The Senior Director of Clinical Review will monitor the Clinical Review Nurse 's activities and outcomes, ensuring compliance with established… more
- Mount Sinai Health System (New York, NY)
- …information requested by the managed care companies as part of the concurrent review in a timely fashion. * Provides clinical information requested by the ... plan of care and coordination of services based on clinical needs and available resources. 3. Utilization Review...monitoring of discharge planning process in collaboration with the clinical nurse initiates the discharge planning process… more
- VNS Health (Manhattan, NY)
- … review of all components related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical ... team, or care manager generated requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable state… more
- Northwell Health (Staten Island, NY)
- **Req Number** 144355 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality patient ... Responsibilities: + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria… 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
- Northwell Health (Valley Stream, 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
- VNS Health (Manhattan, NY)
- … review of all components related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical ... team, or care manager generated requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable state… more
- Catholic Health Services (Roslyn, NY)
- …being addressed and treated. QUALIFICATIONS: Minimum of 5 years recent staff nurse clinical acute care in-patient experience required. Critical care experience ... responsible for improving the overall quality and completeness of clinical documentation within the inpatient record. Perform concurrent...preferred. Education: Registered Nurse (BSN preferred), Nurse Practitioner or Physician… more
- VNS Health (Manhattan, NY)
- … review of all components related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical ... team, or care manager generated requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable state… more
- Catholic Health Services (Roslyn, NY)
- Overview REGISTERED NURSE CLINICAL DATA COORDINATOR St. Francis Hospital & Heart Center(R) is New York State's only specialty designated cardiac center. A member ... guides as appropriate to their role. Performs appropriate targeted concurrent review to improve accuracy and compliance...appropriately requested. NYS RN license with 7+ years of clinical experience. Chart review skills. Knowledge of… more
- Mount Sinai Health System (New York, NY)
- …information requested by the managed care companies as part of the concurrent review in a timely fashion. c. Provides clinical information requested by the ... for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission).… more
- Mount Sinai Health System (New York, NY)
- …information requested by the managed care companies as part of the concurrent review in a timely fashion. 3. Provides clinical information requested by the ... for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission).… more
- VNS Health (Manhattan, NY)
- …of organizational or state-wide trends that affect utilization trends and the impact that concurrent review and a high-quality plan of care for discharge has on ... management teams to generate timely requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable… more
- Molina Healthcare (New York, NY)
- …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care ... state, and local laws and regulatory requirements affecting the medical and clinical staff. **Job Duties** + Provides medical oversight and expertise in… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …+ Assess discharge planning needs at the patient's admission + Perform regular concurrent review on all patients and coordinate all needed services including ... Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of… more