- 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
- Molina Healthcare (Yonkers, NY)
- …will be supporting our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals and Grievances experience and a clinical ... production levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in...unrestricted license preferred. **Required Experience** + Minimum two years UM , CM, MAT, HM, DM, and/or managed care… 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 (Yonkers, 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
- 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)
- …as assigned. Qualifications Licenses and Certifications:Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York ... (MCG) preferredFor UM Only: Experience must be with a Managed Care Organization or Health Plan.For SelectHealth ETE Only: Experience in Public Health… more
- Molina Healthcare (Yonkers, NY)
- _This position requires an actively licensed Registered Nurse_ **JOB DESCRIPTION** **Job Summary** The mission of Clinical Operations is to drive value through an ... model concept design. + Collaborate with other COE leaders across the enterprise UM , LTSS, BH, Quality, Office of the CMO, Network, Government Contracts, Growth and… more