- Elevance Health (Woodbridge, NJ)
- …Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. + Partners ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review of exception… more
- Molina Healthcare (Manhattan, NY)
- …who are eligible for Medicaid and Medicare. We are looking for Registered Nurse Care Review Clinicians with Prior Authorization experience. Experience with ... Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse (LVN) or...social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital… more
- Hackensack Meridian Health (Hackensack, NJ)
- …fellows, pediatric residents, neonatal PAs and neonatal nurse practitioners, nurses, dieticians, respiratory therapists, social workers, ... is at least 1 shift every 2 weeks** **The Advanced Practice Nurse or Physician Assistant performs the role utilizing the patient-centered coordinated care… more
- Centene Corporation (New York, NY)
- …criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care + ... care to members + Provides feedback on opportunities to improve the authorization review process for members + Performs other duties as assigned + Complies with… more
- Centene Corporation (New York, NY)
- …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers on utilization… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **The Hackensack University Medical Center Night Shift RRT Nurse Practitioner or Physician Assistant performs the role utilizing the patient-centered ... practice. 5. Participates in APRN interviewing, credentialing, and peer review process as requested. 6. Participates in a minimum...staff leaders to support nursing-led protocols to enhance the nurse 's ability to function at their highest level of… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **Inpatient Cardiology Advanced Practice Nurse Provider (APN) for Hackensack UMC** **performs the role utilizing the patient-centered coordinated care ... practice. 5. Participates in APRN interviewing, credentialing, and peer review process as requested. 6. Participates in a minimum...staff leaders to support nursing-led protocols to enhance the nurse 's ability to function at their highest level of… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Part Time John Theurer Cancer Center Nurse Practitioner performs the role utilizing the patient-centered coordinated care model demonstrated through ... practice. 5. Participates in APRN interviewing, credentialing, and peer review process as requested. 6. Participates in a minimum...staff leaders to support nursing-led protocols to enhance the nurse 's ability to function at their highest level of… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Neurocritical Care Advanced Practice Nurse or Physician Assistant performs the role utilizing the patient-centered coordinated care model ... practice. 5. Participates in APRN interviewing, credentialing, and peer review process as requested. 6. Participates in a minimum...staff leaders to support nursing-led protocols to enhance the nurse 's ability to function at their highest level of… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **The Hackensack University Medical Center Psychiatry Nurse Practitioner or Physician Assistant Per Diem performs the role utilizing the ... of specialty practice.** **5. Participates in APRN interviewing, credentialing, and peer review process as requested.** **6. Participates in a minimum of one… more
- Molina Healthcare (New York, NY)
- …DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level ... quality of care issues. + Assists with Complex Claim review including DRG Validation, Itemized Bill Review ,...Claim review including DRG Validation, Itemized Bill Review , Appropriate Level of Care, Inpatient Readmission, and any… more
- Hackensack Meridian Health (Totowa, NJ)
- **Overview** **The Hennessy Institute at John Theurer Cancer Center Nurse Practitioner performs the role utilizing the patient-centered coordinated care model ... practice. 5. Participates in APRN interviewing, credentialing, and peer review process as requested. 6. Participates in a minimum...staff leaders to support nursing-led protocols to enhance the nurse 's ability to function at their highest level of… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title: Nurse Practitioner- Heart Hospital-Mount Sinai Hospital- Full Time- Day** A nurse practitioner (NP) as described in Title VIII, ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion… more
- Mount Sinai Health System (New York, 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
- Mount Sinai Health System (New York, NY)
- **Job Description** A Nurse Practitioner is certified under section 6910 of the New York State Education Law and licensed as a registered nurse . A nurse ... continuum. **Qualifications** Master's degree program designed to prepare a registered nurse to provide acute/primary health care services or the successful… more
- Mount Sinai Health System (New York, 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
- Children's Aid (Manhattan, NY)
- …On a monthly basis review medication inventory and provide a report to Nurse Clinical Manager. * Perform Visual Exams per protocol for children in foster care. * ... Licensed Practical Nurse 12/11/24Full Time--Manhattan Job ID: 007369 Description: Dunlevy...required by the RN. * On a bi-monthly basis review vaccine inventory and order vaccines accordingly. * Routinely… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Clinical Nurse is a Registered Professional Nurse who provides safe, competent quality care based on nursing theory and research to a ... process and its application + Licensed as a registered nurse with current registration in New York State +...Care, 5 Minute Sit Down, Purposeful Hourly Rounding, Medication Review , Discharge Wrap Up, and MD/RN Unit Collaboration. 2.… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Job Title: Clinical Nurse -MedSurge-Stepdown-10W-Mount Sinai Hospital-FT/Nights The Clinical Nurse is a Registered Professional Nurse who ... process and its application + Licensed as a registered nurse with current registration in New York State +...Care, 5 Minute Sit Down, Purposeful Hourly Rounding, Medication Review , Discharge Wrap Up, and MD/RN Unit Collaboration. +… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **3005812: Staff Nurse - 4W Cardiac Surgery Stepdown - Mount Sinai Morningside - Part Time Day** **Strength Through Diversity** Ground breaking ... process and its application + Licensed as a registered nurse with current registration in New York State +...Care, 5 Minute Sit Down, Purposeful Hourly Rounding, Medication Review , Discharge Wrap Up, and MD/RN Unit Collaboration. +… more