- Centene Corporation (New York, NY)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- RWJBarnabas Health (Jersey City, NJ)
- Nurse Midwife-FT Days-MMG Concurrent -Jersey City-NJReq #:0000192215 Category: Nurse Midwife Status:Full-Time Shift:Day Facility:Jersey City Medical Center ... Department:MMG Concurrent Location: Jersey City Medical Center, 355 Grand Street,...Street, Jersey CIty, NJ 07302 Job Summary: The Certified Nurse Midwife position provides antepartum, intrapartum, postpartum, neonatal and… 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
- Hackensack Meridian Health (Maywood, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Registered Nurse Care Manager** is a member of the healthcare team and is responsible for ... coordinating, communicating and facilitating the clinical progression of the patient's treatment and discharge plan...**Responsibilities** A day in the life of a **Registered Nurse Care Manager** at **Hackensack Meridian** **_Health_** includes: +… more
- Northwell Health (Huntington, NY)
- **Req Number** 152919 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 (Mount Kisco, 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)
- …Develops forms, record abstracts, reports, and other tools used to implement concurrent and retrospective patient/member case review , including the design, ... testing and evaluation of the review methodology. + Oversees the quality review ...and current registration to practice as a Registered Professional Nurse or Licensed Clinical Social Worker LCSW)… 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
- 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
- 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
- WMCHealth (Valhalla, NY)
- …Internal Applicant link Job Details: Job Summary: Provides clinically based concurrent review of patient medical records to ensure documentation ... Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Professional/Non- Clinical Department: Health Info Mgmt-WMC Health Union: No Position:… more
- Molina Healthcare (Yonkers, NY)
- …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care ... national, state, and local laws and regulatory requirements affecting the medical and clinical staff. + Required MD licenses in the following states: **AZ, WA,** FL,… more
- Molina Healthcare (Manhattan, NY)
- …community and accessing and using durable medical equipment (DME). * Experience in utilization review , concurrent review and/or risk management a plus. * ... corrections and revision of CHA paperwork and tasking tool documentation based on review and feedback provided through quality and associated review process.… more
- Hackensack Meridian Health (North Bergen, NJ)
- …reviews for appropriateness of admission and continued hospital stay applying appropriate clinical criteria. Performs admission review within 24 hours or the ... team and is responsible for coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient… 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
- Elevance Health (New Hyde Park, NY)
- …Requires HS diploma or equivalent. + Requires a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid and ... ensuring appropriate, consistent administration of plan benefits by reviewing clinical information and assessing medical necessity under relevant guidelines and/or… more