- VNS Health (Manhattan, NY)
- …CEU credits, and advancement opportunities What You Will Do + Reviews specific utilization issues or requests with Clinical Review team, focusing on problem ... Manages and evaluates staff in delivery and coordination of utilization management review services in compliance with...and current registration to practice as a registered professional nurse in New York State Required + Valid driver's… more
- City of New York (New York, NY)
- …CAS works with other programs at HRA and with other governmental and non -governmental service providers to create new programs and to integrate and refine existing ... CAS Visiting Psychiatric Services (VPS) Unit is recruiting for two (2) Psychiatric Nurse Practitioner for the roles below. Under the supervision of the Medical… more
- Elevance Health (New York, NY)
- …4 years managed care experience and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of education ... the Elevance Health major office (PulsePoint) location listed above. The **Medical Management Nurse ** is responsible for review of the most complex or… more
- Molina Healthcare (Yonkers, 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 cases… more
- Wellpath (Valhalla, NY)
- …care through adherence to policies and procedures for admission and transfer, utilization review , and referrals. + Assumes responsibility and accountability for ... Every day we have the distinct honor and responsibility to show up with non -judgmental compassion to provide hope and healing to those who need it most. For… more
- FlexStaff (Tarrytown, NY)
- …of experience in care/case management, disease management, population health management, utilization review , quality assurance, or discharge planning (preferably ... **Req Number** 148876 FlexStaff is seeking a Registered Nurse (Field Clinical Assessments/UAS) to work for one...to work for one of our external clients, a non -profit organization that provides home healthcare services to the… more
- Nuvance Health (Carmel, NY)
- …years RN experience in an acute care setting; Leadership experience preferred; Utilization review , discharge planning or case management experience preferred. ... locations, including The Heart Center, a leading provider of cardiology care. Non -acute care is offered through various affiliates, Education: BSN / BSW preferred… more
- Nuvance Health (Danbury, CT)
- …strategic leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non -clinical support staff while ... *System Care Coordination Leader* will be responsible for leading a team encompassing utilization review and denials/appeals specialists and will need to foster… more
- Mount Sinai Health System (New York, NY)
- …The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse , Physician Assistant, or Nurse Practitioner, who manages the 24 ... and supporting patient-centered care. **Qualifications** ? Must be a Licensed Registered Nurse , Physician Assistant or Nurse Practitioner Registered Nurse … more
- Nuvance Health (Norwalk, CT)
- …principal liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and Health Information Management to ensure ... The Heart Center, a leading provider of cardiology care. Non -acute care is offered through various affiliates, *$25K SIGN...coming in from other hospitals. Responsibilities: 1. Manages the Utilization Review elements of the ED encounter… more
- WMCHealth (Valhalla, NY)
- …and coding principles and guidelines; good knowledge of healthcare delivery system, utilization review , case review and quality improvement practice ... Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Professional/ Non -Clinical Department: Health Info Mgmt-WMC Health Union: No Position:… more
- Richmond Community Services (Mount Kisco, NY)
- …of "reportable" for the Justice Center or DDRO. Maintains a file of non -reportable complaints with supporting rationale. 3. Oversees and ensures proper entry into ... necessary reviews are completed. 5. Collaborates with Program Administrators to ensure the timely review of all incidents that do not rise to the level of reportable… more
- Nuvance Health (Danbury, CT)
- …principal liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate ... The Heart Center, a leading provider of cardiology care. Non -acute care is offered through various affiliates, Hours: 40...level within the care continuum. Provides clinically based concurrent review of the medical record to assess and procure… more
- New York State Civil Service (Thiells, NY)
- …research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or ... Family Care Providers are trained on the plans.* Present behavior plans to review committees such as the Human Rights Committee (HRC) and Informed Consent Committees… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The (per diem) Utilization Review Specialist coordinates scheduling of all surgical/endoscopic hospital admissions, pre-admission testing and ... operating room procedures. This individual seeks the assistance of the Nurse Manager in identifying cases, which require pre admission screening or have questionable… more