- 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)
- **Overview** **The Med Surg Telmetry Unit Per Diem Advanced Practice Nurse performs the role utilizing the patient-centered coordinated care model demonstrated ... 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)
- …fellows, pediatric residents, neonatal PAs and neonatal nurse practitioners, nurses, dieticians, respiratory therapists, social workers, ... to care for complex neonatal ICU patients.** **The Advanced Practice Nurse or Physician Assistant performs the role utilizing the patient-centered coordinated… 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 Pediatric and Adolescent Dermatology Nurse Practitioner performs the role utilizing the patient-centered coordinated care model demonstrated ... and ethical decision making. The NP will join three Pediatric Dermatologists and a Nurse Practitioner in the Paramus office. This position is 5 days a week, Monday… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **The Nurse Practitioner performs the role utilizing the patient-centered coordinated care model demonstrated through the following competencies: ... and ethical decision making. Cardiology or acute care experience Nurse Practitioner preferred.** **Responsibilities** **Leadership 1. Participates in decisions… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **The John Theurer Cancer Center Nurse Practitioner performs the role utilizing the patient-centered coordinated care model demonstrated through the ... consultation/collaboration, coaching/guiding, research, and ethical decision making.** **This Oncology Nurse Practitioner position focuses on myeloma - majority inpatient,… 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 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
- 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 (Hackensack, NJ)
- **Overview** **The Cardiac Surgery Nurse Practitioner provides clinical oversight and management of the patients in the cardiac surgery intensive care unit ... practice. 5. Participates in APN 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 ... nursing process and its application Licensed as a registered nurse with current registration in New York State Name:...Care, 5 Minute Sit Down, Purposeful Hourly Rounding, Medication Review , Discharge Wrap Up, and MD/RN Unit Collaboration. 2.… more