• Utilization Review Coordinator, (NY…

    New York State Civil Service (Bronx, NY)
    …to conduct a non -competitive promotion examination for the position of Utilization Review Coordinator at New York City Children's Center. Permanent ... NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York City Children's Center - Bronx Campus, P25595 Occupational… more
    New York State Civil Service (03/04/25)
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  • Utilization Review Coordinator, (NY…

    New York State Civil Service (Queens Village, NY)
    …conduct a non -competitive promotion examination for the position of Utilization Review Coordinator at Creedmoor Psychiatric Center. Permanent appointment may ... NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), Creedmoor Psychiatric Center, P25684 Occupational Category Health… more
    New York State Civil Service (03/12/25)
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  • Manager, Utilization Management Operations…

    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
    VNS Health (03/14/25)
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  • Registered Nurse Case Manager-Child…

    Hackensack Meridian Health (Maywood, NJ)
    …duties with attention to detail and in a timely manner. + Collaborates with Utilization Review Nurses. + Provides Important Message, ABN, Observation letter as ... serve as a leader of positive change. The **Registered Nurse Care Manager** is a member of the healthcare...patient management. + Knowledge of health care delivery system, utilization and review and case review more
    Hackensack Meridian Health (01/03/25)
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  • VPS Psychiatric Nurse Practitioner

    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
    City of New York (02/12/25)
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  • Medical Management Nurse

    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
    Elevance Health (03/13/25)
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  • Clinical Appeals Nurse (RN): Texas and New…

    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
    Molina Healthcare (02/09/25)
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  • Psychiatric Nurse Practitioner

    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
    Wellpath (01/14/25)
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  • Registered Nurse Clinical Assessments/UAS…

    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
    FlexStaff (01/26/25)
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  • Clinical Program Manager, Clinical Command Center;…

    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
    Mount Sinai Health System (03/04/25)
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  • Advanced Medical Support Assistant

    Veterans Affairs, Veterans Health Administration (Bronx, NY)
    …coordinated care delivery model. Coordinates] with the patient care team to review clinic [appointment availability] ( utilization ) [ ] to ensure that ... Appointments (VCC), VetText, and Vetlink. The AMSA will assist in ensuring clinic utilization is optimized and effectively supports the needs of the organization and… more
    Veterans Affairs, Veterans Health Administration (03/14/25)
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  • RN Case Manager - ED- $25,000 Sign on Bonus

    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
    Nuvance Health (03/12/25)
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  • Clin. Documentation Specialist

    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
    WMCHealth (02/20/25)
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  • Director of Case Management

    Calvary Hospital (Bronx, NY)
    …responsible for the coordination of the hospital-wide functions of Case Management, Utilization Review and Discharge Planning. Oversees and coordinates the ... and their families. Through a caring, compassionate, philosophy of non -abandonment, the hospice provides a full spectrum of palliative...of five (5) years of experience in Case Management, Utilization Review or Discharge Planning required. +… more
    Calvary Hospital (03/11/25)
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  • Director of Quality

    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
    Richmond Community Services (03/12/25)
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  • Care Delivery Manager

    CenterLight Health System (Ridgewood, NY)
    …religious backgrounds, and congenital or acquired disabilities. JOB RESPONSIBILITIES: + Review and ensure effective development and execution of personalized care ... needed. + Serve as a manager on call during non -operational hours of the physical sites and responsible for...Delivery reports. + Participates and represents the Community Health Nurse (CHN) in all IDT meetings, when required. +… more
    CenterLight Health System (01/16/25)
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  • Psychologist 2

    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
    New York State Civil Service (01/03/25)
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  • Medical Management Clinician Associate (US)

    Elevance Health (New Hyde Park, NY)
    …or equivalent. + Requires a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... not require the training or skill of a registered nurse . **How you will make an impact** Primary duties...made by a Medical Director. + Refers complex or non -routine reviews to more senior nurses and/or Medical Directors.… more
    Elevance Health (03/13/25)
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  • Per Diem Perioperative Scheduling…

    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
    Mount Sinai Health System (02/22/25)
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