- 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
- 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
- Atlantic Health System (Morristown, NJ)
- The Clinical Documentation Specialist will facilitate modifications to clinical documentation, through concurrent interactions with physicians and other ... clinicians to reflect appropriate clinical severity, complications and co-morbidity....and all comorbid conditions after study. Completes the initial review within 24-48 hours of admission. Completes concurrent… more
- Northwell Health (Staten Island, NY)
- **Req Number** 149225 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
- 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)
- …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
- 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
- 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 ... state, and local laws and regulatory requirements affecting the medical and clinical staff. **Job Duties** + Provides medical oversight and expertise in… more
- Penn Medicine (Plainsboro, NJ)
- …less experienced staff. 1. Communicates relevant clinical information, including admission review , concurrent review , and discharge planning needs, to ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… 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
- RWJBarnabas Health (New Brunswick, NJ)
- …coverage for patients professional visits and treatments. Updates insurance companies with concurrent review of information as necessary to obtain referrals or ... appropriate billing systems + Coordinates with the physician or nurse as needed to obtain clinical information....physician or nurse as needed to obtain clinical information. Retrieves information from patient medical record to… more