• Clinical Review Nurse

    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
    Centene Corporation (01/10/25)
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  • Staff Nurse - Case Manager- Mount Sinai…

    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
    Mount Sinai Health System (10/16/24)
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  • Transition of Care Registered Nurse

    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 (01/02/25)
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  • Registered Nurse Case Manager-Child…

    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
    Hackensack Meridian Health (01/03/25)
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  • Registered Nurse (RN) Case Manager

    Northwell Health (Huntington, NY)
    …Patients Discharge Instruction Sheet and the Patient Transfer Sheet. + Ensures Patient Review Instrument (PRI) is completed and reflects clinical profile of the ... clinical pathways, variance analysis and trending, quality management/utilization review and home care/discharge planning, preferred. + Keeps abreast of… more
    Northwell Health (01/03/25)
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  • Clinical Documentation Specialist (CCDS…

    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 (01/07/25)
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  • Clinical Evalution Manager, RN- mostly…

    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 (01/03/25)
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  • Clinical Evaluation Manager-mostly remote…

    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 (12/06/24)
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  • Quality Improvement Specialist, Clinical

    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 (12/04/24)
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  • Clinical Data Coord

    Catholic Health Services (Roslyn, NY)
    Overview REGISTERED NURSE CLINICAL DATA COORDINATOR St. Francis Hospital & Heart Center(R) is New York State's only specialty designated cardiac center. A member ... procedures and guides as appropriate to their role. Performs appropriate targeted concurrent review to improve accuracy and compliance if indicated. Performs… more
    Catholic Health Services (11/14/24)
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  • RN/Case Manager-MSH-Case Management-FT-Days

    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 (01/01/25)
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  • Case Manager RN-Mount Sinai Morningside- Per Diem-…

    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 (01/08/25)
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  • RN Case Manager - Unit

    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
    Nuvance Health (12/18/24)
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  • Medical Director

    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
    Molina Healthcare (12/26/24)
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  • RN Case Manager, Inpatient

    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
    Memorial Sloan-Kettering Cancer Center (12/30/24)
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