- Guthrie (Cortland, NY)
- Summary The LPN Utilization Management (UM) Reviewer , in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and the ... Packer Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior… more
- Evolent (Albany, NY)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical /Vocational Nurse with a current, ... the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks… more
- Guthrie (Binghamton, NY)
- …leadership and autonomy in nursing practice. + Preferred experience with care management / utilization review , and payer knowledge. + RN considered. ... accredited LPN program Licenses: + The Wellness Nurse must be licensed in both New...The applicant must have a current license as a Practical Nurse in their state of practice… more
- Centene Corporation (New York, NY)
- …preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN - Licensed Practical Nurse - State Licensure ... findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and… more
- Datavant (Albany, NY)
- …it relates to job function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of...knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered… more
- DePaul (Rochester, NY)
- …+ Performs all other duties as assigned. Qualifications + Registered Nurse or Licensed Practical Nurse with 3 years of experience in long-term care; ... Management Plan within the corporation. + Incident Management - review incident reports and provide...reporting and follow-up consultation and training. + Responsible for Utilization Record Review functions to include Individual… more
- University of Rochester (Rochester, NY)
- …(RHIT) Program Preferred **_or_** + Licensure/credentials in clinical specialty such as Registered Nurse , Licensed Practical Nurse , or Emergency Medical ... requests, and external oversight: ie) NYS DOH, ACS Committee on Trauma Registry Management : + Monitor security of data to ensure the integrity and reliability of… more
- Elevance Health (Latham, NY)
- …or equivalent. + Requires a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN /LVN ... The **Medical Management Clinician Associate** is responsible for ensuring appropriate, consistent administration of plan benefits by reviewing clinical information… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Coordination Specialist provides administrative support for any of the programs of Utilization Management , Behavioral Health, Quality Management , or Member ... and review timeliness, workflow volumes, referrals generated to care management programs + Provides administrative support to the grievance and appeals process… more
- Elderwood (Waverly, NY)
- …Companies + Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review . Managed Care Coordinator Skills and Competencies + Demonstrated ... Overview Mon-Fri 8am-4pm The Managed Care Coordinator assists and supports the LPN /RN MDS Coordinator with case management responsibilities. The candidate is… more
- CDPHP (Latham, NY)
- …The pharmacy tech will participate in an on-call/holiday rotation along with a utilization management pharmacist to support Plan members in after hour pharmacy ... of that experience. Under the direct supervision of a licensed pharmacist, the Managed Care Pharmacy Technician (Pharmacy Tech)...prescription and medical benefits as it applies to the utilization review process. + Must demonstrate proficient… more
- Nuvance Health (Poughkeepsie, NY)
- …to the position. * Performs patient care within the scope of practice as a Nurse (RN or LPN ), Respiratory Therapist, EMT, Paramedic. * Keeps complete and ... operator assists in the provision of safe and therapeutic management of patient care to an assigned group of...in the respective field of qualifying credential (eg, Registered Nurse , LPN , Respiratory Therapist, EMT or Paramedic)… more
- Bassett Healthcare (Herkimer, NY)
- …enjoy the best quality of life possible. What you'll do The Registered Professional Nurse I, Acute Care is accountable for the delivery of safe patient care ... and job description is only appropriate for a new nurse in the first year of practice, as support...than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. +… more
- Bassett Healthcare (Delhi, NY)
- …enjoy the best quality of life possible. What you'll do The Registered Professional Nurse IV, Acute Care is accountable for the delivery of safe patient care ... no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. + Analyzes assessment data… more
- Bassett Healthcare (Cobleskill, NY)
- …Schoharie County and the surrounding region What you'll do The Registered Professional Nurse (RN), Acute Care in the Medical Inpatient Unit is accountable for the ... needs. The RN contributes to the support of patients through interdisciplinary teamwork. + Registered Nurse I: The RN I status is only appropriate for a new nurse… more
- Bassett Healthcare (Cooperstown, NY)
- …enjoy the best quality of life possible. What you'll do The Registered Professional Nurse III, Acute Care is accountable for the delivery of safe patient care ... no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. + Analyzes assessment data… more
- Bassett Healthcare (Cooperstown, NY)
- …and enjoy the best quality of life possible. What you'll do The Discharge Nurse is accountable for the delivery of safe patient care utilizing the nursing process. ... The Discharge Nurse assesses, plans, delivers, coordinates, integrates, and evaluates nursing...than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback +… more
- Bassett Healthcare (Cooperstown, NY)
- …care through research and educational activities. + Assists in the creation and/or management of a triage tool to direct patients toward the appropriate specialty ... care of complex patients. + Ensures effective tracking of test results, medication management , and adherence to follow-up appointments where applicable. + Acts as an… more
- CDPHP (Latham, NY)
- …with Medicaid Long Term Care Programs preferred. + Minimum of two (2) years Utilization Management experience is preferred. + Experience with the New York State ... Manager and the success of the member-focused Complex Case Management Programs. Qualifications: + Registered Nurse with...York State license is required. BS in Nursing preferred. LPN plus one year of experience with CDPHP will… more
- Bassett Healthcare (Cooperstown, NY)
- …exceptions, as measured by direct supervisory observation and random supervisory chart review + Demonstrates consideration of safety, effective utilization of ... quality of life possible. What you'll do The STAT Nurse RN will provide clinical support and direct patient...than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback +… more