- 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
- City of New York (New York, NY)
- …appointments; tracking and receiving test results; entering results into EMR; perform utilization/ concurrent review on all screening tests as well as on ... of New York (FDNY), seeks a full-time Case Management Nurse in the Bureau of Health Services, World Trade...nursing from an accredited college, and three years of clinical nursing experience; or 2. A valid New York… more
- Northwell Health (Port Jefferson, NY)
- …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. ... collaboration with the health care team. + Conducts chart review for appropriateness of admission and continued length of...and continued length of stay; Facilitates throughput. + Conducts clinical reviews and interacts with third party payers to… 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)
- OverviewLeads interdepartmental quality improvement activities such as development and engagement, clinical review , clinical risk management, and patient ... Develops forms, record abstracts, reports, and other tools used to implement concurrent and retrospective patient care review , including the design, testing… 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
- 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
- Mount Sinai Health System (Long Island City, NY)
- …Social Service Department. + When managed care denies payment for days during concurrent review , contact the attending with this information. The attending can ... across the continuum. Ensuring and facilitating the achievement of quality, clinical and cost outcomes; Negotiating, procuring and coordinating services and… more
- Nuvance Health (Norwalk, CT)
- …are executed to the appropriate level within the care continuum. Provides clinically based concurrent review of the medical record to assess and procure accurate ... *$20K SIGN ON BONUS - FOR ELIGIBLE EXTERNAL CANDIDATES* Summary: The Clinical Care Coordinator - Unit is responsible for providing direction and leadership… more
- Nuvance Health (Norwalk, CT)
- …are executed to the appropriate level within the care continuum. Provides clinically based concurrent review of the medical record to assess and procure accurate ... *Description* Summary: The Clinical Care Coordinator - Unit is responsible for...between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate status is… more