- VNS Health (Manhattan, NY)
- …in development of plans to address improvement needs as appropriate. * For Utilization Management Only: * Issues Determinations, Notices of Action, and other ... communications required by state or federal regulations are saved in the Utilization Management System. * Reviews, evaluates and determines the appropriateness… more
- VNS Health (Manhattan, NY)
- …Delivers timely notification detailing clinical decisions. Coordinates with management , subject matter experts, physicians, member representatives, and discharge ... planners in utilization tracking, care coordination, and monitoring to ensure care...cost effective. Works under general supervision. This position is mostly remote (minimum of 1x per month in the… more
- VNS Health (Manhattan, NY)
- …years' experience in a Grievance and Appeals or related area such as medical or utilization management in a Managed Care setting required + Experience in a ... Plans is seeking a dedicated Manager, Grievance and Appeals ( RN )to lead the daily operations of our grievance and...+ License and current registration to practice as a registered professional nurse in New York State… more