- 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
- NJM Insurance (Trenton, NJ)
- … clinical information and updates needed to effectively and accurately perform concurrent review . + Identify medical and community needs and facilitate/assist ... uphold, modify, or overturn prior decisions. + Conduct Inpatient Care utilization review using NJM and evidence-based clinical guidelines to ensure appropriate… more
- Hackensack Meridian Health (Neptune, NJ)
- …to transform healthcare and serve as a leader of positive change. The ** Clinical Documentation Specialist Registered Nurse (RN)** facilitates improvement in the ... to the unit. **Responsibilities** A day in the life of a ** Clinical Documentation Specialist Registered Nurse (RN)** at **Hackensack Meridian** **_Health_**… more
- CVS Health (Trenton, NJ)
- …Jersey as one of the following: Licensed Clinical Social Worker (LCSW), Registered Nurse (RN), Clinical Nurse Specialist (CNS), Licensed Clinical ... experience in managed care Utilization Management to include prior authorization, concurrent review OR demonstrated experience in providing behavioral health… 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
- 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
- Vitalief (New Brunswick, NJ)
- …in New Brunswick, NJ. Job Responsibilities: + Under the direct supervision of the Nurse Manager of Clinical Research Center (CRC), you will be responsible for ... clients adapt to evolving requirements in the research and clinical trial industry with cutting-edge solutions. Reasons to Work...plus. + Ability to work on 12 to 15 concurrent trials - must have strong organizational and prioritization… 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 ... Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to the enterprise. Primary responsibilities will include… 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
- Hackensack Meridian Health (Holmdel, 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
- Hackensack Meridian Health (Neptune, 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