- Centers Plan for Healthy Living (Jamaica, NY)
- UM RN 90-27 Sutphin Blvd, Jamaica, NY 11435, USA Req #12129 Monday, December 2, 2024 Centers Plan for Healthy Living's goal is to create the ultimate healthcare ... and plans they need for healthy living. JOB SUMMARY: The Utilization Management nurse works within a multidisciplinary team to help identify and manage members who… more
- VNS Health (Manhattan, NY)
- …assigned. Qualifications Licenses and Certifications: + Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York ... Certified Case Manager preferred + For SelectHealth ETE Only: Nurse Practitioner (NP) certification with background or degree in...+ Knowledge of Milliman criteria (MCG) preferred + For UM Only: Experience must be with a Managed Care… more
- Molina Healthcare (New York, NY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Yonkers, NY)
- …improvement experience **Preferred License, Certification, Association** + Active, unrestricted State Registered Nursing ( RN ) license in good standing. + ... _Candidates must possess a current RN license, as well as a Bachelor's Degree_...+ Collaborate with other COE leaders across the enterprise UM , LTSS, BH, Quality, Office of the CMO, Network,… more
- Molina Healthcare (Yonkers, NY)
- …acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must ... Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other Molina offices or… more
- VNS Health (Manhattan, NY)
- …as assigned. Qualifications Licenses and Certifications:Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York ... State requiredCertified Case Manager preferredFor SelectHealth ETE Only: Nurse Practitioner (NP) certification with background or degree in Public Health… more
- BronxCare Health System (Bronx, NY)
- …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... purpose of reporting and implementing corrective measures. - Provide feedback to UM staff related to denial prevention strategies. - Participates in JCAHO hospital… more
- Catholic Health Services (Melville, NY)
- …party contractual changes from the Managed Care Department and applies to UM and appeals management processes. | Works collaboratively with physicians, physician ... | Graduate of an accredited Nursing School or College; current New York State, RN License required, BSN Bachelor of Science in Nursing or Health preferred. | Minimum… more