- Centene Corporation (New York, NY)
- …**Must have a New York State license or identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review ... and determination. Completes data entry and correspondence as necessary for each review . + Conducts rate negotiation with non -network providers, utilizing… more
- New York State Civil Service (Bronx, NY)
- …to conduct a non -competitive promotion examination for the position of Utilization Review Coordinator at New York State Psychiatric Institute. Permanent ... NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), NYC Children's Center, Bronx Campus, P25875 Occupational Category… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Review Admission Specialist (OR Scheduler), Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The ... Utilization Review Specialist coordinates scheduling of all...and operating room procedures. Seeks the assistance of the Nurse Manager in identifying cases, which require pre admission… more
- 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
- Mount Sinai Health System (Manhattan, NY)
- **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion… 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
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **The Advanced Practice Nurse (APN) will reflect the mission, vision and values of Hackensack Meridian Health (HMH). They will comply with all relevant ... when no longer indicated. If properly trained, remove lines when needed. 8. Review all patients on assigned floor(s) with Restraints Orders daily. Ensure the… 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
- Mount Sinai Health System (New York, NY)
- …the Nursing Department. The Staffing Office collaborates with Nursing Leadership to review and develop schedules based on agreed upon staffing guidelines, models and ... health care experience + 2+ years related experience, required with Associates degree Non -Bargaining Unit, M71 - Nursing Staff Office - MSH, Mount Sinai Hospital… more
- VNS Health (Manhattan, NY)
- …others as applicable. * Evaluates branch operations; analyzes trends in volume, utilization , and other business drivers to understand the impact these factors have ... per action plans. * Audits and approves visit and non -visit payroll activities in HCHB; creates payroll batches each...for the visit. * Leads weekly IDT meetings to review /discuss patient status/issues. Determines if patients that are planned… more
- Mount Sinai Health System (New York, NY)
- …to influence other services by focusing on patient processes. 10.Develops and implements Utilization Review (UR) based on internal data collection, data received ... 5 years case management and 6 years as clinical nurse . Previous supervisory experience in case management or related...York State + Certification in case management is preferred Non -Bargaining Unit, BEZ - Utilization Management -… more
- CenterLight Health System (Ridgewood, NY)
- …ensure appropriate regulatory compliance. + Serves as administrative on call during non -operational hours of the physical sites. + Collaborates with departments to ... that further membership growth. + Responsible for following expenditure and utilization targets. Track Metrics + Hospital admissions/readmissions. + Budgetary. + NH… more
- Mount Sinai Health System (New York, NY)
- …records, internal and external regulatory and survey requirements. The Clinical Nurse Manager collaborates with multiple professionals to support and coordinate the ... & family as well as the organization. The Clinical Nurse Manager is the Nursing Leader of their designated...communication. + Critical thinking and organizational skills are essential. Non -Bargaining Unit, LAI - HSO Pharmacy Home Infusion- STL,… more
- 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
- 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
- FlexStaff (Ridgewood, NY)
- …hospitalization reports, family, and team meetings. + Develops and participates in the Utilization Review of medical services. + Develops and supervises the ... 141767 FlexStaff is seeking a Site Physician for our client, a non -profit healthcare organization providing home and community-based healthcare and services for the… more
- VNS Health (Manhattan, NY)
- …care review , including the design, testing and evaluation of the review methodology. + Performs utilization and quality assessment reviews to maintain ... interdepartmental quality improvement activities such as development and engagement, clinical review , clinical risk management, and patient satisfaction. Serves as a… more
- BAYADA Home Health Care (New York, NY)
- …+ Experience developing performance improvement plans, field staff orientation, clinical chart review , and utilization review reporting + Strong assessment ... the state of New York in good standing + SIM educator responsibilities for Nurse Residency would be required + Trach/vent experience required + Ability to travel to… more
- Mount Sinai Health System (New York, NY)
- …Mount Sinai Medical Center to ensure efficient delivery of non -financial services to practices of participating physicians. **Qualifications** Education: associate ... space and facilities for subsequent performance of duties. Optimize exam utilization and physician/APP session 2. Ensures adequate staffing for unexpected/emergency… more
- Molina Healthcare (Yonkers, NY)
- …3 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management. + Minimum 2 years ... for special needs populations including, but not limited to Duals, LTSS and non -LTSS_ + _Clinical model design for Medicaid, Medicare and Marketplace lines of… more