- Centene Corporation (New York, NY)
- …clinical license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care… 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 ... health management systems according to utilization management policies and guidelines + Works with healthcare...or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title - Nurse Practitioner-Pediatric Cardiology - Mount Sinai Hospital - Full Time - Day** A nurse practitioner (NP) as described in ... 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 (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 (Long Island City, 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
- Veterans Affairs, Veterans Health Administration (Kings County, NY)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. Independently provides patient-centered and recovery-oriented care and… more
- Project Renewal, Inc. (New York, NY)
- …in the development and implementation of quality assurance management and utilization review + Participates in interdisciplinary meetings with shelter ... Title: Primary Care Nurse Practitioner - Part Time Program: Healthcare Department...$87,000 depending on experience Position Overview: The Primary Care Nurse Practitioner working in Mobile Health is responsible for… more
- Elevance Health (Woodbridge, NJ)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
- Hackensack Meridian Health (Edison, NJ)
- …New Jersey program and its Quality Metrics. + Knowledge of health care delivery system, utilization and review and case review procedures. + Knowledge of ... EPIC. **Licenses and Certifications Required** : + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support HCP Certification. **Licenses… more
- Northwell Health (Staten Island, NY)
- …case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. + Keeps ... concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of stay. + Contacts… more
- Mount Sinai Health System (New York, NY)
- …Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager ... are not limited to: a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using… more
- Mount Sinai Health System (New York, NY)
- …The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse , Physician Assistant, or Nurse Practitioner, who manages the 24 ... and supporting patient-centered care. **Qualifications** Must be a Licensed Registered Nurse , Physician Assistant or Nurse Practitioner Registered Nurse… more
- Elevance Health (New York, NY)
- …members and providers. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology regimens ... and supportive care. + Perform physician-level case review , following initial nurse review ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- Hackensack Meridian Health (Edison, NJ)
- …performance of the national STS/TVT, ACC-NCDR, and NJDHSS CV databases. Develops utilization of the Cardiovascular Registry Program to its full potential, by ... continually providing database utilization education, and training of appropriate personnel, including the CV Registry abstractor(s), regarding accurate and complete… more
- Mount Sinai Health System (New York, NY)
- …communication and interpersonal skills. + Current certification and registration as a Nurse Practitioner in New York State + Current license and registration as ... a Professional Registered Nurse in NY State + National Board Certification in...approach to care delivery. + Performs a patient record review with the collaborating physician in a timely fashion… more
- Deloitte (New York, NY)
- …nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN, Quality, DRG Validation and health ... in nursing, medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical Documentation Specialist - CCDS… more
- Hackensack Meridian Health (Red Bank, NJ)
- …ED inpatient admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance ... experience. **Licenses and Certifications Required:** + Current state Registered Nurse license. + Certified Clinical Documentation Specialist (CCDS) or certification… more
- Erickson Living (Tinton Falls, NJ)
- …and dehydration. + Participating in Wound Rounds, Operations Meetings, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) ... a plus. + Minimum 3 years' experience in a healthcare leadership role (Charge Nurse , Unit Manager, etc.). + Experience with an electronic medical record (EMR) system… more
- Hackensack Meridian Health (Edison, NJ)
- …Skills and Abilities Preferred: 1. Knowledge of milliman and/or interqual criteria, utilization review , discharge planning and case management. Licenses and ... Certifications Required: 1. NJ State Professional Registered Nurse License. 169637 Minimum rate of $59.89 Hourly HMH is committed to pay equity and transparency for… more