- Molina Healthcare (Manhattan, NY)
- …people who are eligible for Medicaid and Medicare.** **We are looking for Registered Nurse Care Review Clinicians with Prior Authorization experience. ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies...Education** Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse… more
- Nuvance Health (Norwalk, CT)
- …cardiology care . Non-acute care is offered through various affiliates, * Registered Nurse or Masters Social Work with management experience* *$30K SIGN ON ... in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a...not required. MSW considered Minimum Experience: five years Desired: Registered Nurse with management experience . Knowledge… more
- Molina Healthcare (New York, NY)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional… more
- Nuvance Health (Danbury, CT)
- …in nursing, health administration, or a related field preferred * Current licensure as a registered nurse (RN) * Minimum of 5 years of clinical experience in an ... *Description* *Summary:*The *System Care Coordination Leader* will serve as a pivotal...ensure CMS and regulatory compliance.* *Develop and maintain a UM plan to guide the team with detailed processes… more
- BronxCare Health System (Bronx, NY)
- …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... and develop strong appeals for the purpose of securing reimbursement for acute care services provided to patients. Assist in development of strategies for denial… more
- VNS Health (Manhattan, NY)
- …assigned. Qualifications Licenses and Certifications: + Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York ... Certified Case Manager preferred + For SelectHealth ETE Only: Nurse Practitioner (NP) certification with background or degree in...UM Only: Experience must be with a Managed Care Organization or Health Plan. + For SelectHealth ETE… more