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Utilization Management / Appeals Registered Nurse. Nursing / Utilization Management. Knowledge of Utilization Management, Appeals, or Clinical Documentation PREFERRED.

Job Description Empowerment Academy has three campuses, an Elementary School, Middle School, and High School. We are hiring a School Nurse to serve all of our students. You will be working on a team of 4 nurses and you will primarily be based out of the Middle School. Salary: $72,000-$87,000 Hours: 7:15am-3:45pm (may vary by campus) Why Our School is Special Empowerment Academy is a highly successful charter school that truly supports its teachers and staff. We serve a student mix that is among the most diverse in America while enjoying the cultural vibrance of Jersey City, Hoboken and New York City. If this appeals to you, then apply today! We have achieved academic success without burning out our staff by meshing an effective education program with effective staff supports and professional development. We truly value our faculty and work hard to control other costs so we can focus our resources on supporting them. In fact, throughout our history, we have annually increased faculty salaries by more than at other public schools and now, among those with similar experience, OUR FACULTY MEMBERS ARE AMONG THE HIGHEST PAID IN NEW JERSEY. New Jersey charter schools ARE public schools. Our staff is part of the Pension in New Jersey. Nurse Responsibilities • Carrying out written orders of the medical home and standing orders of the school physician;, • Conducting health screenings which include height, weight, blood pressure, hearing, vision and scoliosis;, • Monitoring vital signs and general health status for emergent issues for students suspected of being under the influence of alcohol and controlled dangerous substances;, • Maintaining student health records;, • Recommending to the school principal those students who shall not be admitted to or retained in the school building based on a parent‘s failure to provide evidence of the child‘s immunization according to specified schedules;, • Annually reviewing student immunization records to confirm with the medical home that the medical condition for the exemption from immunization continues to be applicable;, • Recommending to the school principal exclusion of students who show evidence of communicable disease;, • Directing and supervising the emergency administration of epinephrine and training school staff designated to serve as delegates;, • Administering asthma medication through use of a nebulizer;, • Directing and supervising the health services activities of any school staff to whom the certified School Nurse has delegated a nursing task;, • When appropriate, transmitting a summary of relevant health and medical information to a Child Study Team;, • Writing and updating, at least annually, the individualized health care plan and the individualized emergency healthcare plan for students’ medical needs and instructing staff as appropriate;, • Implementing and assisting in the development of healthcare procedures for students in the event of an emergency;, • Instructing teachers on communicable disease and other health concerns;, • Providing other nursing services consistent with the School Nurse‘s certification;, • Collaborating with staff in grade-level and department planning meetings, and in professional development activities;, • Helping with school-wide activities and providing supervision of students during class, breaks, and meals when needed;, • Any other tasks dictated by the School Principal related to student health and wellness;, • Assisting with tasks necessary for the successful and orderly functioning of the school (such as hallway supervision, arrival/departure transitions, field trips, and other such duties as the school leadership may request from staff); and, • The Candidate needs to possess School Nurse certification in New Jersey. (We would consider someone with an RN/BSN who is looking to enroll in a School Nurse Certification program immediately upon being hired.), • School Nurse experience preferred., • Excellence in communication and organization skills., • Demonstrated ability to work effectively with students, families, staff and community with diverse backgrounds., • Demonstrated aptitude or competence for assigned responsibilities., • Health Care Plan (Medical, Dental & Vision), • Retirement Plan, • Paid Time Off (Vacation, Sick & Public Holidays), • Family Leave (Maternity, Paternity), • Short Term & Long Term Disability, • Training & Development As an equal opportunity employer, Empowerment Academy hires without consideration to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, or disability. INDSUPPORT

Job Description Appeals Nurse VillageCareMAX 112 Charles Street, New York, NY 10014 VillageCare is looking for a self-motivated and passionate RN for our Appeals Nurse position. While supporting the Utilization Management team, the Appeals Nurse will conduct comprehensive analytic reviews of clinical documentation. This dynamic role will allow you to use your clinical knowledge to make authorization decisions, and assist with appeal determinations. Some of your responsibilities will include the following: • Collect information concerning eligibility, provider status, benefit coverage, coordination of benefits and subrogation necessary to reach prospective, concurrent and retrospective decisions in the appeals process., • Review and interpret a variety of instructions and medical notes furnished in written and oral form to determine appropriate action towards appeal., • Write sound, factual, clinical arguments and attend Administrative Law Judge hearings for warranted appeals., • Detect problems, recognize important information, and link various data will be vital to this position. We would like to speak to those who have a current unrestricted NYS RN license to practice professional nursing. Seeking those who bring a BSN (Master's degree preferred), along with 5+ years of practical experience in healthcare setting and 3+ years of quality management. Prior experience with analyzing data and knowledge of regulatory governance for CMS/DOH requirements required. Must reside in the NY tri-state area: NY, NJ, or CT There are many benefits to working for VillageCare. If you are someone who likes being part of a team, enjoys a highly competitive benefits package from world leading carriers and competitive compensation, than we would love to speak with you! • PTO package, • 10 Paid Holidays, • Personal and Sick time, • Medical/Dental/Vision, • HRA/FSA, • Education Reimbursement, • Retirement Savings 403(b), • Life & Disability, • Commuter Benefits, • Paid Family Leave, • Additional Employee Discounts VillageCare offers a wide range of at-home and community-based services, as well as managed long-term care options that seek to match each individual's needs to help them attain and maintain the greatest level of independent living possible. We are committed to superior outcomes in quality health care. VillageCare is an Equal Opportunity Employer. Job Posted by ApplicantPro

Job Description Overview Physician Affiliate Group of New York (PAGNY) is adding an Adult Unit Chief to the Inpatient Unit at NYC Health + Hospitals/Kings County. The Behavioral Health Center offers a comprehensive suite of services for mental health including First Episode Psychosis program, medical services, opioid treatment, substance use disorders services, a specialized unit for people with Intellectually Disability, an inpatient Extended care unit focusing on the needs of our homeless patients and prevent recidivism, ketamine assisted therapy, and inpatient and outpatient services for adults and children. Our skilled team—including adult and child and adolescent psychiatrists, psychologists, internists, nurses, social workers, creative arts therapists, peer counselors and addiction counselors delivers compassionate care in a secure environment, respecting each patient's dignity and partnering with them on their recovery journey. We also provide educational resources for patients and caregivers to enhance their understanding of mental health and addiction issues and available treatments. Our services range from psychopharmacology and various forms of psychotherapy (individual, group, and family) to specialized programs like outpatient withdrawal management, medication maintenance (including Methadone and Buprenorphine), overdose prevention, and support for personal development goals such as employment and education. Each patient receives a personalized assessment and treatment plan tailored to their specific needs, ensuring a holistic approach to recovery and health management. The hospital maintains a strong academic affiliation with SUNY Downstate Health Sciences University to maintain its high healthcare delivery standards and to provide its staff with teaching and research opportunities and the chance to work with medical students, residents and fellows very closely. The mission of NYC Health + Hospitals is to extend equally to all New Yorkers, regardless of the ability to pay, comprehensive health services of the highest quality in an atmosphere of humane care, dignity, and respect. Their Values are built on a foundation of social and racial equity and has established the ICARE standards for all staff. Responsibilities The Unit Chief collaborates with a robust interdisciplinary treatment team, including nurses, psychologists, clinical pharmacists, social workers, licensed creative arts therapists, and peer counselors to oversee daily operations of an Adult Inpatient Behavioral Health Unit. Oversee Unit Clinical Structure • Establish and oversee interdisciplinary teams and team meetings, • Ensure that community meetings and other therapeutic groups take place as scheduled, • Participate in Behavioral Codes on the unit, providing leadership to the staff and patient community, • Work with all teams on the unit to monitor length of stay and appropriate dispositions, particularly ensuring that:, • Patients who are refusing medications are taken to court promptly, • Patients who have reached their 18th day are referred for state hospitalization for continuing treatment, • Patients who would benefit from AOT are referred promptly, • Other potential barriers to discharge are identified and solved for, • Work with the medical-consultation team ensure that medical problems are properly identified and managed, • Ensure that legal statuses are up to date and accurate, • Provide clinical consultation to teams on your unit, • Assist and supervise unit psychiatrists and nurse practitioners as needed, • Monitor the need for psychiatrist assessments and other components of applications of aftercare, in such applications for appropriate housing, residential placements and state referrals, • Participate in Performance Improvement and Quality Assurance activities, including chart reviews. Educates unit staff members on Performance Improvement, Quality Assurance activities, indicators, etc. and be able to help the unit improve if their performance is below the mean for the service, • In collaboration with risk management reviews major incidents on the inpatient unit, • Assist in the preparation for surveys, • Work with the UM department to conduct MD to MD reviews and participate in any appeals to ensure authorization of inpatient stays, • Maintains focus on key strategic priorities including patient experience, access to care, increased market share, and improving financial stability Qualifications • Must be board eligible or board certified in Psychiatry, • M.D. or D.O. from an accredited school of medicine, • Completed residency training in an accredited program within Psychiatry Annual Base Salary: $257,000 based on 40-hour work week. The annual total value of the compensation package is estimated at $282,700, which includes the baseline salary, 401(k) contribution, and other factors as set forth below: • 401(k) Company Contribution (subject to IRS contribution limits):, • Employees are immediately vested in a 3% company contribution of base earnings. No employee match is required., • After one year of service, employees receive an additional 7% company contribution of base earnings. No employee match is required., • Annual Continuing Medical Education (CME) Reimbursement., • Generous Annual Paid Time Off (PTO): Vacation, Sick, Holiday, and CME days., • Medical, Prescription, and Dental Coverage: Top-tier plans with employee contributions significantly below market rates., • Life Insurance and Accidental Death and Dismemberment (AD&D) Coverage: Equal to 2x your salary (up to a maximum of $300,000) provided at no cost to you., • Additional employee-paid Voluntary Life and AD&D coverage is available for you and your family., • Loan Forgiveness: Position may be eligible for loan forgiveness through certain state or federal programs., • Medical Malpractice Coverage (equivalent to occurrence-based): Provided at no cost to the employee., • Healthcare and Dependent Care Flexible Spending Accounts (FSAs). Physician Affiliate Group of New York, P.C. (PAGNY) is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. We are committed to fostering an inclusive environment where everyone feels valued and respected. Our policies ensure equal opportunities for all. Learn more about our initiatives by visiting our Diversity, Equity, and Inclusion page. *Salary Disclosure Information: The annual base salary listed complies with the New York City law on Salary Transparency in Job Advertisements. The annual base salary listed is for full-time employment and does not include bonuses/incentive compensation or benefits. Actual total compensation depends on many factors, including experience, specialties, historical productivity, and historical collections. **The annual total value of the compensation package shown is provided as an illustration and is not guaranteed.

Job Description Overview Physician Affiliate Group of New York (PAGNY) is adding a Unit Chief to the Inpatient Psychiatry department at NYC Health + Hospitals/Jacobi. Jacobi, located in the Bronx, accommodates more than 325,000 outpatient visits, more than 100,000 emergency room visits and more than 20,000 inpatient admissions annually. The hospital is renowned for The Trauma Center, staffed to treat any traumatic injury or illness, the fully accredited Breast Health Center, and The Burn Center, with more than 40 years of work in burn care. The hospital maintains a strong academic affiliation with Albert Einstein Medical College. The Department of Psychiatry has 89 adult acute inpatient beds, a CPEP, a Consultation-Liaison Service, an Adult Ambulatory Practice, and a Community-Based Assertive Community Treatment Program. The department employs evidenced-based best practices in providing the highest quality care to its patients, in a patient-centered approach that is respectful of their individuality, culture, and community. The mission of NYCHHC is to extend equally to all New Yorkers, regardless of the ability to pay, comprehensive health services of the highest quality in an atmosphere of humane care, dignity, and respect. Their Values are built on a foundation of social and racial equity and has established the ICARE standards for all staff. Responsibilities The Unit Chief collaborates with a robust interdisciplinary treatment team, including nurses, psychologists, clinical pharmacists, social workers, licensed creative arts therapists, and peer counselors to oversee daily operations of an Adult Inpatient Behavioral Health Unit. Oversee Unit Clinical Structure • Establish and oversee interdisciplinary teams and team meetings, • Ensure that community meetings and other therapeutic groups take place as scheduled, • Participate in Behavioral Codes on the unit, providing leadership to the staff and patient community, • Work with all teams on the unit to monitor length of stay and appropriate dispositions, particularly ensuring that:, • Patients who are refusing medications are taken to court promptly, • Patients who have reached their 18th day are referred for state hospitalization for continuing treatment, • Patients who would benefit from AOT are referred promptly, • Other potential barriers to discharge are identified and solved for, • Work with the medical-consultation team ensure that medical problems are properly identified and managed, • Ensure that legal statuses are up to date and accurate, • Provide clinical consultation to teams on your unit, • Assist and supervise unit psychiatrists and nurse practitioners as needed, • Monitor the need for psychiatrist assessments and other components of applications of aftercare, in such applications for appropriate housing, residential placements and state referrals, • Participate in Performance Improvement and Quality Assurance activities, including chart reviews. Educates unit staff members on Performance Improvement, Quality Assurance activities, indicators, etc. and be able to help the unit improve if their performance is below the mean for the service, • In collaboration with risk management reviews major incidents on the inpatient unit, • Assist in the preparation for surveys, • Work with the UM department to conduct MD to MD reviews and participate in any appeals to ensure authorization of inpatient stays, • Maintains focus on key strategic priorities including patient experience, access to care, increased market share, and improving financial stability Qualifications • Must be board-eligible or board-certified in Psychiatry, • M.D. or D.O. from an accredited school of medicine, • Completed residency training in an accredited program within Psychiatry Annual Base Salary: $257,000 based on 40-hour work week. The annual total value of the compensation package is estimated at $322,700, which includes the baseline salary, 401(k) contribution, and other factors as set forth below: • Projected bonus of up to $40,000 (based on previous year’s average), contingent upon meeting quality and productivity targets., • 401(k) Company Contribution (subject to IRS contribution limits):, • Employees are immediately vested in a 3% company contribution of base earnings. No employee match is required., • After one year of service, employees receive an additional 7% company contribution of base earnings. No employee match is required., • Annual Continuing Medical Education (CME) Reimbursement., • Generous Annual Paid Time Off (PTO): Vacation, Sick, Holiday, and CME days., • Medical, Prescription, and Dental Coverage: Top-tier plans with employee contributions significantly below market rates., • Life Insurance and Accidental Death and Dismemberment (AD&D) Coverage: Equal to 2x your salary (up to a maximum of $300,000) provided at no cost to you., • Additional employee-paid Voluntary Life and AD&D coverage is available for you and your family., • Loan Forgiveness: Position may be eligible for loan forgiveness through certain state or federal programs., • Medical Malpractice Coverage (equivalent to occurrence-based): Provided at no cost to the employee., • Healthcare and Dependent Care Flexible Spending Accounts (FSAs). Physician Affiliate Group of New York, P.C. (PAGNY) is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. We are committed to fostering an inclusive environment where everyone feels valued and respected. Our policies ensure equal opportunities for all. Learn more about our initiatives by visiting our Diversity, Equity, and Inclusion page. *Salary Disclosure Information: The annual base salary listed complies with the New York City law on Salary Transparency in Job Advertisements. The annual base salary listed is for full-time employment and does not include bonuses/incentive compensation or benefits. Actual total compensation depends on many factors, including experience, specialties, historical productivity, and historical collections. **The annual total value of the compensation package shown is provided as an illustration and is not guaranteed.

Responsibilities Review and maintain daily mail, faxes and emails received by the Appeals Department to ensure information is accurate and saved electronically, updating memos, and maintaining various weekly/monthly logs, including but not limited to cumulative mail and call volume logs. Assist supe

Job description Are you a passionate, dedicated Registered Nurse looking for a rewarding career in Home Health Care? Do you value a supportive and positive work environment? If so, then Affirmed Home Care is the place for you! We are currently seeking a Registered Nurse Case Manager to join our rapi

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