- 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
- RWJBarnabas Health (Livingston, NJ)
- …and social work functions, medical necessity determinations, and concurrent review . Qualifications: Required: + Minimum 5 years clinical experience in ... advocacy, oversight of nursing and social work functions, medical necessity determinations, and concurrent review . + Ensure that Case Management Department is in… more
- Hackensack Meridian Health (Neptune, NJ)
- …to transform healthcare and serve as a leader of positive change. The ** Clinical Documentation Specialist Registered Nurse (RN)** facilitates improvement in the ... to the unit. **Responsibilities** A day in the life of a ** Clinical Documentation Specialist Registered Nurse (RN)** at **Hackensack Meridian** **_Health_**… more
- Atlantic Health System (Morristown, NJ)
- The Clinical Documentation Specialist will facilitate modifications to clinical documentation, through concurrent interactions with physicians and other ... clinicians to reflect appropriate clinical severity, complications and co-morbidity....and all comorbid conditions after study. Completes the initial review within 24-48 hours of admission. Completes concurrent… 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
- Hackensack Meridian Health (Maywood, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Registered Nurse Care Manager** is a member of the healthcare team and is responsible for ... coordinating, communicating and facilitating the clinical progression of the patient's treatment and discharge plan...**Responsibilities** A day in the life of a **Registered Nurse Care Manager** at **Hackensack Meridian** **_Health_** includes: +… more
- Northwell Health (Lake Success, NY)
- … clinical documentation in the patient's medical record through a concurrent review process throughout the patient's inpatient stay. 4.Requests clarification ... of clinical documentation from the physician(s) on a ...date. *Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications… more
- Northwell Health (Staten Island, NY)
- **Req Number** 144355 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality patient ... Responsibilities: + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria… more
- Prime Healthcare (Passaic, NJ)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/179762/bonus-available%21 supervisor%2c-case-management registered- nurse /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilitySt. Mary's General Hospital… 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
- 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
- Vitalief (Newark, NJ)
- …on-site in Newark, NJ. Job Responsibilities: + Under the direct supervision of the Nurse Manager of Clinical Research Center (CRC), you will be responsible for ... clients adapt to evolving requirements in the research and clinical trial industry with cutting-edge solutions. Reasons to Work...plus. + Ability to work on 12 to 15 concurrent trials - must have strong organizational and prioritization… 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
- Molina Healthcare (New York, NY)
- …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care ... state, and local laws and regulatory requirements affecting the medical and clinical staff. **Job Duties** + Provides medical oversight and expertise in… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …+ Assess discharge planning needs at the patient's admission + Perform regular concurrent review on all patients and coordinate all needed services including ... Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of… more
- Hackensack Meridian Health (Holmdel, NJ)
- …reviews for appropriateness of admission and continued hospital stay applying appropriate clinical criteria. Performs admission review within 24 hours or the ... team and is responsible for coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient… more
- Hackensack Meridian Health (Neptune, NJ)
- …reviews for appropriateness of admission and continued hospital stay applying appropriate clinical criteria. Performs admission review within 24 hours or the ... team and is responsible for coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient… more