• Appeals Manager , Department

    BronxCare Health System (Bronx, NY)
    …Management Position Type Regular Full-Time Division Bronxcare- Yonkers Max USD $97,125.00/Yr. Shift Day Shift Department : Name Appeals Department (BHCS) ... the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to… more
    BronxCare Health System (09/18/24)
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  • Manager , Grievance and Appeals , RN

    VNS Health (Manhattan, NY)
    …navigating the complexities of healthcare? VNS Health Plans is seeking a dedicated Manager , Grievance and Appeals (RN)to lead the daily operations of our ... management of clinical appeals review processes within Appeals & Grievances Department . + Manages the...Relations, Claims, Medical Director, third party administrator, pharmacy benefit manager , to achieve resolution of appeals and… more
    VNS Health (09/04/24)
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  • Utilization Review Manager -Selikoff…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
    Mount Sinai Health System (10/31/24)
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  • Emergency Department RN Case Manager

    Mount Sinai Health System (New York, NY)
    …homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5 years? experience as a ... **Job Description** The Case Manager (CM) will be responsible for all aspects...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
    Mount Sinai Health System (10/10/24)
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  • RN/Case Manager -MSH-Case Management-Full…

    Mount Sinai Health System (New York, NY)
    …homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5 years experience as a ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
    Mount Sinai Health System (08/30/24)
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  • Staff Nurse- Case Manager - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED patients and ... basis and identify the expected length of stay (ELOS). The case manager works collaboratively with physicians, social workers, clinical nurses, home care services,… more
    Mount Sinai Health System (10/16/24)
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  • Director, Behavioral Health, Health Plans

    VNS Health (Manhattan, NY)
    …+ Engages in and contributes to the interdisciplinary team's utilization management activities and recommended interventions for members/participants. Establish ... and implementation of the behavioral health sections of the Quality Management (QM)/ Utilization Management (UM) Plan. Oversees the administration of all BH QM/UM and… more
    VNS Health (09/04/24)
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  • Deputy Registrar (Office of the Registrar,…

    CUNY (New York, NY)
    …of the Registrar. . Analyzes data, delegates assignments to ensure maximum utilization of capacities of staff, support in the development and implementation of ... directed by the Registrar. . Represents the Registrar at key meetings with Deans, Department Chairs and acts on his/her behalf as directed. . Under the direction of… more
    CUNY (09/19/24)
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