Utilization Review Nurse Jobs in New York City, New York
11 New York City, NY Utilization Review Nurse jobs found on Monster.
Full time opportunity in Manhattan for RN with utilization review experience for managed health plan. Immediate opportunity, experience with chronic illness preferred and Spanish speaking a plus....
Utilization Review RN - Managed Care New York, NY Job Summary: The Utilization Review Nurse is responsible for utilization management, utilization review, or concurrent review (telephonic inpatient care management). The UR Nurse will performs reviews of current inpatient services, and determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines...
A nationally recognized Managed Care Organization in NYC is looking for a Utilization Management Case Manager. Responsibilities: Performs pre-authorization, concurrent and retrospective reviews of Medicare/Medicaid/Commercial members to evaluate appropriateness of admission, need for continued stay, length of stay, utilization of resources, patient outcomes, and usage of other services post-encoun...
Health care As a Case Manager you will serve as liaison between the patient and facility/physician. You will also ensure a continuum of quality patient care throughout hospitalization and oversees provisions for patient's discharge, assess, plan, oversee and evaluate the appropriateness of care throughout admission and hospitalization of the patient. Facilitates patient management throughout hospi...
Description: Evercare is now part of the OptumHealth division under the greater UnitedHealth Group. We have 9 teams of Complex Care Nurse Practitioners spread across the New York metro market and are looking to expand the team by 30 to 40 percent in 2013. This growth is not only a testament to our modelâs success but the efforts, care, and commitment of our Nurse Practitioners; some of whom have b...
Description As a part of the Tenet and Catholic Health Initiatives family, Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 600 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. Through our revenue cycle management , patient comm...
Summary: Provide case management and clinical services to employees within their regulated scope of practice Major Responsibilities: • Manage Short Term Disability by tracking claims and communicate case status to employees, supervisors/mangers, hrSource, Human Resources and healthcare providers. • Facilitate and be a resource to employees in a smooth transitional (modified) or full return to work...
Ensures that prospective new and active enrollees/members are appropriately screened by assessment staff to meet eligibility requirements. Ensures that an initial and ongoing service plans are developed implemented and communicated with all relevant parties. Directs the daily operations of scheduling, staffing needs, clinical coordination and liaison with Human Resource Administration (HRA). Parti...
The Manager Appeals & Grievances ("MAG") serves as the advanced level subject matter expert for determination of non-clinical and clinical matters. The MAG supervises day-to-day departmental activities including, but not limited to, oversight for four or more staff and the A&G processes. This position will work from 100 Church Street with a flexible work arrangement allowing the option to work rem...
We are seeking a Nurse Supervisor for our new CHHA. Responsible for implementation and supervision of clinical programs and objectives of the Manhattan Home Care Department. Directs clinical staff development and implementation of patient plan of care includes provision of care by all disciplines. Plans and develops clinical in-service and on-going education programs. Monitors program expenditures...
Director of Clinical Reimbursement Position Summary: The Regional Director of Clinical Reimbursement assures the management of the Medicare, Managed Care and Medicaid reimbursement system for a region-specific number of skilled nursing facilities. This position reports directly to the Vice President of Clinical Reimbursement. In this role you will be responsible for regulatory compliance and quali...
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Nurse Manager
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$87,360.00 - $115,000.00
Typical Salary for Nurse Manager in New York City
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Master's
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20%
Bachelor's
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©2013 Monster - All Rights Reserved U.S. Patents No. 5,832,497; 7,599,930 B1; 7,827,125 and 7,836,060 MWW - Looking for Monster Cable? - V: 2013.5.0.223-218