- Mount Sinai Health System (New York, NY)
- …Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will...Supports the mission, vision, philosophy and goals of the Medical Center. + Promotes an environment that is sensitive… more
- Mount Sinai Health System (New York, NY)
- …on units as warranted. 2. Meets with Case Managers, as warranted, to review medically complex and long stay cases; refer to physician advisor as indicated. ... 10. Attends interdisciplinary rounds as necessary. 11. Meets with Case Managers to review medically complex...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED patients ... specified timeframes. * Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using… more
- Mount Sinai Health System (New York, NY)
- …Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will...Supports the mission, vision, philosophy and goals of the Medical Center. 6. Promotes an environment that is sensitive… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Director of Case Management is responsible for the overall operation of the Case Management Department. This includes oversight of daily ... care to patients. This involves the delivery of comprehensive front-line Case Management services, including utilization management, care facilitation and discharge… more
- RWJBarnabas Health (Long Branch, NJ)
- …RN -Full Time DayReq #:0000158872 Category:Nursing Status:Full-Time Shift:Day Facility:Monmouth Medical Center Department: Case Management Location: Monmouth ... a highly dedicated RN to work per diem in Case Management for Monmouth Medical Center. Monmouth...3 to 5 years acute care RN experience + Case Management experience Preferred: + Utilization Review … more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical information ... with Third Party Payor requirements preferred. Non-Bargaining Unit, 329 - Case Management - MSH, Mount Sinai Hospital **Responsibilities** + **Admission: Payer… more
- Travelers Insurance Company (New York, NY)
- …investigating, evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims. Provides quality claim handling throughout the claim ... of policy information to facts or allegations of each case . + Work with Manager on use of Claim...as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent… more
- CVS Health (Somerset, NJ)
- …and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. The ICM ... and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and...member's overall wellness. * Uses clinical tools and information/data review to conduct an evaluation of member's needs and… more
- Elevance Health (Woodbridge, NJ)
- **Telephonic Nurse Case Manager II** **Location: This is a virtual position. Prefer candidates reside within 50 miles of an Elevance Health Pulse Point location.** ... within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure… more
- Mount Sinai Health System (New York, NY)
- …1-3 years related administrative or business experience Non-Bargaining Unit, BGG - Case Management - STL, Mount Sinai St. Luke's **Responsibilities** 1. Develop and ... quality and timeliness of data 9. Manages data through review , computerization, cleaning and auditing for compliance with standard...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- City of New York (New York, NY)
- …medical accommodations - Supervision of administrative physicians assigned to review medical accommodations - Completes Accommodation Reviews (Home ... Job Description City Medical Specialist II / Complex Care...needs at school - Reviews and assists with in-school case management - Manages complex clinical cases… more
- Mount Sinai Health System (New York, NY)
- … medical leadership when appropriate + Documents authorization review for medical and pharmacy claims. + Prepares case reports, summaries, or other ... in the area of nursing practice assigned; in this case , acute care utilization review . + Previous...to modify and/or add necessary services. + Performs continuing review of medical records; analyzing data trends… more
- J&J Family of Companies (New Brunswick, NJ)
- …**Principal Duties & Responsibilities:** + Assess product risk-benefit and offer medical input/ review to: Risk Management Reports, Product Issue assessment/ ... considered. Remote work options may be considered on a case -by- case basis and if approved by the...of AEs that the customer experienced. + Be the medical representative within the review process when… more
- Elevance Health (Woodbridge, NJ)
- …determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review ). + Provides information regarding network ... information regarding case and...complex cases. + May act as liaison between Medical Management and/or Operations and internal departments. + Maintains… more
- Mount Sinai Health System (New York, NY)
- …with the physician and shall reflect accepted standards of nursing and medical practice. Protocols shall include provisions for case management including ... in accordance with written policies approved by nursing and medical administration and manage a clinical program throughout the...in the specific clinical area and performs a periodic review of the collaborative agreement. b. Assesses the health… more
- VNS Health (Manhattan, NY)
- …components related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical providers, ... Reviews requests for outpatient and inpatient admission; approves services or consults with medical directors when case does not meet medical necessity… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **The Department of Emergency Medicine seeks a Medical Director to lead the Mount Sinai-Union Square Urgent Care Center (MSUS UCC).** This role ... supports the implementation of medical and clinical policies, services and procedures within the...practice manager and nurse manager to develop agenda and review data prior to meeting + Defines and implements… more
- International Rescue Committee (New York, NY)
- …child is released from custody into a sponsor's care (Home Study) + Provide case management support via remote and / or conducting in-home visits to ensure the ... and Senior Caseworkers (Level 2), as well advises Crisis Case Managers (Level 3). Specifically, the Casework Supervisor ensures...Act as a point of escalation for staff with complex cases, cases of concern, and client crisis. This… more
- Mount Sinai Health System (New York, NY)
- …- FT Days M-F 8AM-4PM** The Coding Specialist III is responsible for the review and coding of complex inpatient and/or ambulatory surgery records utilizing ... is utilized for reimbursement, clinical care assessment, education, research, case mix and health care statistical reporting. **Qualifications** **Education… more