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About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review/Medical and Case Management services for Group Health and Workers’ Compensation and other Casualty clients. The Workers’ Compensation Nurse Case Reviewer collaborates with medical care providers, employers, employees, and at times, attorneys to support the appropriate return to work, the provision of necessary medical services, and the evaluation of coverage under the Plan. The Nurse Case Manager reports to the Casualty Department Manager. Primary Responsibilities • Collaborates with workers' compensation patients, employers, providers, and claims adjusters to coordinate medical and disability services for timely return to work, • Provides case management, utilization review, continued stay reviews, and based on clinical judgment and state WCB Medical Treatment Guidelines, • Knowledgeable and compliant with New York State Workers’ Compensation Law, Medical Treatment Guidelines, ERISA, HIPAA confidentiality requirements, and NY Formulary Review process, • Proven ability to anticipate claimant's treatment or recovery milestones, • Provides Case Management services, including assessing barriers to recovery and determining treatment alternatives, • Facilitates and expedites discharge planning as needed, • Produces accurate electronic records of individual cases, • Ensures timely, cost-effective medical care for injured workers' recovery, • Answers provider calls and assists with Casualty Department workload as necessary, • Kind, caring, and positive with all customers and fellow employees, • Adheres to established quality assurance standards and MagnaCare policies and procedures Essential Qualifications • Currently licensed Registered Nurse in the state of NY, or the ability to obtain, • Maintain current licensure(s) and specialty certifications that are relevant to this position; CCM is encouraged, • Minimum 1 year experience in worker’s compensation case management, • Bachelor’s degree preferred, • Minimum of 4 years’ experience in a clinical environment required, • Strong skills in medical assessment/medical record review, • Excellent customer service skills, • Ability to define and solve problems, collect data, establish facts and make effective decisions a must., • Must be detail oriented and have strong organizational and time management skills, and the ability to work independently., • Ability to work proficiently on a computer (PC) with working knowledge of Microsoft Office, especially Word, Excel Teams, and Outlook Powered by JazzHR zEGYw9cEHB

Job Description As a Clinical Reviewer you will complete the full spectrum of activities related to State Independent Review Organization (IRO) case determinations. You will conduct clinical level review, determine physician level assignment, manage case staging between external physician experts and manage appeal processes within strict deadlines. Duties include but are not limited to: • Conducting reviews up to and including the appeal level. This includes chart screening, writing case summaries, determining documentation adequacy, researching insurer requirements, complete decision templates and preparing final determinations., • Act as a resource for the administrative and clinical staff in training, problem solving, and clarifying determinations., • Training and mentoring new RNs as the project expands., • Understanding multi-state requirements. QUALIFICATIONS: • Knowledge and experience with electronic medical records., • Ability to oversee, problem solve and work collaboratively with peers, medical, analytical, and administrative support staff., • Excellent written and verbal skills., • Ability to work independently with little supervision., • Ability and desire to be flexible, innovative, and creative., • New York Licensed Registered Nurse, required., • A bachelor’s degree in nursing OR graduate of an approved Registered Professional Nurses training program, required. The salary range and/or hourly rate listed does not include other forms of compensation or benefits. IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, protected veteran status or military status.

Job DescriptionAbout The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review/Medical and Case Management services for Group Health and Workers’ Compensation and other Casualty clients. The Workers’ Compensation Nurse Case Reviewer collaborates with medical care providers, employers, employees, and at times, attorneys to support the appropriate return to work, the provision of necessary medical services, and the evaluation of coverage under the Plan. The Nurse Case Manager reports to the Casualty Department Manager. Primary Responsibilities • Collaborates with workers' compensation patients, employers, providers, and claims adjusters to coordinate medical and disability services for timely return to work., • Provides case management, utilization review, continued stay reviews, and based on clinical judgment and state WCB Medical Treatment Guidelines., • Knowledgeable and compliant with New York State Workers’ Compensation Law, Medical Treatment Guidelines, ERISA, HIPAA confidentiality requirements, and NY Formulary Review process., • Proven ability to anticipate claimant's treatment or recovery milestones., • Provides Case Management services, including assessing barriers to recovery and determining treatment alternatives., • Facilitates and expedites discharge planning as needed., • Produces accurate electronic records of individual cases., • Ensures timely, cost-effective medical care for injured workers' recovery., • Answers provider calls and assists with Casualty Department workload as necessary., • Kind, caring, and positive with all customers and fellow employees., • Adheres to established quality assurance standards and MagnaCare policies and procedures.Essential Qualifications, • Currently licensed Registered Nurse in the state of NY, or the ability to obtain., • Maintain current licensure(s) and specialty certifications that are relevant to this position; CCM is encouraged., • Minimum 1 year experience in worker’s compensation case management., • Bachelor’s degree preferred., • Minimum of 4 years’ experience in a clinical environment required., • Strong skills in medical assessment/medical record review., • Excellent customer service skills., • Ability to define and solve problems, collect data, establish facts and make effective decisions a must., • Must be detail oriented and have strong organizational and time management skills, and the ability to work independently., • Ability to work proficiently on a computer (PC) with working knowledge of Microsoft Office, especially Word, Excel Teams, and Outlook. Powered by JazzHR zEGYw9cEHB

Job Description As a Coding Reviewer, you will be responsible for the general coding validation and verification and preparation of independent dispute resolution reviews from external state and federal agencies in accordance with reporting requirements. Duties include but are not limited to: • Confirm and verify submitted codes for DRG validation., • Apply national coding standards and regulations to the claims and clinical data., • Provide subject matter input and support agency-wide projects., • Other duties as assigned. This position requires working on-site at the Jericho, NY office. Qualifications: • Excellent interpersonal and communication skills, both written and verbal., • Ability to relate effectively with technical, medical, analytical and administrative personnel., • Proficiency in EHR applications, office technology, and Microsoft applications including Word, Excel, and PowerPoint., • Being able to handle sensitive and confidential information., • Ability to work in a team environment and independently. Education & Experience: • Licensed Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS)/ Certified Coding Specialist Physician (CCS-P) required., • Technical knowledge of coding and DRG validation with CPT, HCPCS experience and ICD-10 certification required, • Bachelor’s degree in healthcare administration or health information management preferred., • Minimum of two (2) years of experience abstracting and coding of outpatient medical records for billing., • Some experience in utilization reviews preferred. The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The annualized salary range for this position is $65,000.00 – $70,000.00. Actual salary range and/or hourly rate depends on a variety of factors including experience, education, credentials, location, and budget. The salary range listed does not include other forms of compensation or benefits. IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or military status.

Manages patient care in home therapies programs while maintaining cost-effective clinical operations. Directs activities related to the Continuous Quality Assurance Improvement, patient retention and Clinical Algorithm Adoption, patient access management and patient training success.

This role requires clinical judgment, close monitoring, and management of complex patient conditions.

As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning for our managers. As a Clinical Manager, you may

Registered Nurse Unit Manager, RN perform professional supervision, guidance and direction to staff in both clinical and personnel issues on the Sub-Acute (Short Term Unit). Provide support to resident/families in dealing with clinical issues and challenges. Ensure Assessment: Document clinical obse

Registered Nurse (RN) Supervisor Weekends at Centers Healthcare summary:.The Registered Nurse (RN) Supervisor oversees nursing staff and resident care at Beth Abraham Center, primarily during weekends.With a focus on creating a compassionate environment, the role involves scheduling, handling reside

C is a nationwide network of advanced practice providers and specialty clinicians committed to delivering high-quality, proactive care directly to residents in skilled nursing and long-term care facilities.Our partnership with MedElite Healthcare Management Group, empowers us to focus on what matter

Provides additional clinical support programmatically as needed.

This position must comply with the standards of care, which include without limitation assessment of health status, diagnosis, development of plan of care and treatment, implementation of treatment plan, and evaluation of patient status and clinical management.

As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. The Dialysis Clinical Manager Registered Nurse oversees the clinical operations of a dialysis facility, ensuring high-quality patient care and effective ma

Maintains clinical core competency. WHAT'S REQUIRED? • Experience as a Provider is preferred; however, new graduates are welcome to apply! • State License as an APRN or Physician Assistant • Certification as an APRN through the AANP, ANCC, or NCCPA • DEA license, or willingness to obtain upo

Registered Nurse Unit Manager, RN perform professional supervision, guidance and direction to staff in both clinical and personnel issues on the Sub-Acute (Short Term Unit). Provide support to resident/families in dealing with clinical issues and challenges. Ensure Assessment: Document clinical obse

DaVita is a clinical leader! We have the highest percentage of facilities meeting or exceeding CMS's standards in the government's two key performance programs. We expect our nurses to commit to improving patient health through clinical goal setting and quality improvement initiatives.

This position must comply with the standards of care, which include without limitation assessment of health status, diagnosis, development of plan of care and treatment, implementation of treatment plan, and evaluation of patient status and clinical management.

Registered Nurse (RN) Floor Nurse Weekends at Centers Healthcare summary:.Beth Abraham Center is seeking a Registered Nurse (RN) for weekend shifts in Bronx, NY, offering a $3,000 sign-on bonus.The role involves monitoring residents, administering medications, and ensuring quality care through adher

Performs a variety of functions and technical procedures necessary for patient admission, assessment, diagnosis, treatment, follow-up, and outcome evaluation.Participates in performance improvement, research, and educational activities.Takes initial patient histories and performs physical examinatio

This position must comply with the standards of care, which include without limitation assessment of health status, diagnosis, development of plan of care and treatment, implementation of treatment plan, and evaluation of patient status and clinical management.

Nurse Practitioner (NP) or Physician Assistant (PA) – Veteran Disability AssessmentsWe are seeking a dedicated Nurse Practitioner (NP) or Physician Assistant (PA) to join our team in performing medical assessments for

Excellent clinical knowledge and communication skills. Skilled in evidence-based clinical treatment methods and applying varied interventions with patients in crisis.

Clinical nursing experience in a dialysis setting is preferred. Registered Nurse, dialysis nursing, patient care, nursing jobs Bronx, RN jobs NY, healthcare positions, clinical nursing, dialysis treatment, patient education, Centers Dialysis Care.

This position must comply with the standards of care, which include without limitation assessment of health status, diagnosis, development of plan of care and treatment, implementation of treatment plan, and evaluation of patient status and clinical management. Nurse Practitioner, Gastroenterology,

This position must comply with the standards of care, which include without limitation assessment of health status, diagnosis, development of plan of care and treatment, implementation of treatment plan, and evaluation of patient status and clinical management.

RN) Registered Nurse - Med Surgical at Centers Healthcare summary:.As a Registered Nurse at Beth Abraham Center, I provide essential support and care to residents by monitoring their health and administering necessary treatments.I ensure a high standard of care by following infection-control protoco

Performs a variety of functions and technical procedures necessary for patient admission, assessment, diagnosis, treatment, follow-up, and outcome evaluation.Participates in performance improvement, research, and educational activities.Takes initial patient histories and performs physical examinatio

Registered Nurse Unit Manager, RN perform professional supervision, guidance and direction to staff in both clinical and personnel issues on the Sub-Acute (Short Term Unit). Provide support to resident/families in dealing with clinical issues and challenges. Ensure Assessment: Document clinical obse

Assists physician or other provider with clinical procedures, performs telephone triage as needed, and participates in patient teaching. At least two years of recent pertinent professional nursing experience in a hospital, medical office, or other clinical setting.

This position must comply with the standards of care, which include without limitation assessment of health status, diagnosis, development of plan of care and treatment, implementation of treatment plan, and evaluation of patient status and clinical management.

This position is a key clinical role within a growing community program, with the ability to make an impact and offers a significant personal and professional opportunity to join a world-renowned health care organization. Why Work at Parker * Friendly, collaborative team environment and exciting ca

Registered Nurse (RN) Floor Nurse Weekends at Centers Healthcare summary:.As a Registered Nurse (RN) Floor Nurse at Beth Abraham Center in Bronx, NY, the role involves providing care and support to residents, monitoring their health, and administering medications.The position requires excellent comm

Provides clinical direction to the support staff (LPNs, Medical Assistants). Ensures that all clinical equipment is maintained in clean, working order.

Registered Nurse / LDRPN- RN at Centers Healthcare summary:.A Registered Nurse (RN) at Williamsbridge Center in Bronx, NY, provides care and support to residents in a skilled nursing facility.The role involves monitoring residents, administering medications, and documenting care while adhering to in

Conduct patient assessments and complete physical examinations, collect clinical data including vital signs, collecting specimens, prepare patients for tests, therapy, or treatments, order and interpret medical laboratory test results, diagnose medical condition of patient, administer medications or

Working in collaboration with physicians, the NP will assess health status, diagnose conditions, develop and implement treatment plans, and evaluate clinical management. This position must comply with the standards of care, which include without limitation assessment of health status, diagnosis, dev

Each of the facilities in the jail system has unique patient population and environmental characteristics; each psychiatric Nurse Practitioner will be matched with the population that most closely meets their clinical expertise and desired work location and schedule. Engage in clinical supervision,

Registered Nurse Unit Manager, RN perform professional supervision, guidance and direction to staff in both clinical and personnel issues on the Sub-Acute (Short Term Unit). Provide support to resident/families in dealing with clinical issues and challenges. Ensure Assessment: Document clinical obse

Mentor less experienced nurses, offering clinical & career advice.

Registered Nurse Unit Manager, RN perform professional supervision, guidance and direction to staff in both clinical and personnel issues on the Sub-Acute (Short Term Unit). Provide support to resident/families in dealing with clinical issues and challenges. Ensure Assessment: Document clinical obse

In this role, the successful Nurse Practitioner uses clinical expertise to plan the delivery of safe therapeutic population specific patient care through assessment planning implementation and evaluation With the patient and family central to the care incorporates the unique characteristics and need

The Nurse Practitioner (NP) is a nurse who, through clinical experience, study and supervised practice in patient care at the masters or doctoral level, has gained expertise in a specific specialty area of patient care services. Conduct patient assessments and complete physical examinations, collect

Mentor less experienced nurses, offering clinical & career advice. Registered Nurse, Unit Manager, Long Term Care, Nursing, Healthcare, Patient Care, Clinical Supervision, Resident Care, Healthcare Management, Nursing Facility.

This position must comply with the standards of care, which include without limitation assessment of health status, diagnosis, development of plan of care and treatment, implementation of treatment plan, and evaluation of patient status and clinical management.

Candidates should possess an active NY RN License and have clinical nursing experience in a dialysis setting, with a focus on patient care and personalized service. Clinical nursing experience in a dialysis setting is preferred. Registered Nurse, patient care, Bronx NY, clinical nursing, dialysis te

Registered Nurse Unit Manager, RN perform professional supervision, guidance and direction to staff in both clinical and personnel issues on the Sub-Acute (Short Term Unit). Provide support to resident/families in dealing with clinical issues and challenges. Ensure Assessment: Document clinical obse

Registered Nurse (RN) at Centers Healthcare summary:.As a Registered Nurse (RN) at Williamsbridge Center, I provide essential medical care and support to residents in a skilled nursing facility.My responsibilities include administering treatments, monitoring residents' health, documenting care servi

Uses leadership skills/clinical judgment in coordinating patient care and directing/delegating activities of the patient care unit team. Accurately interprets and implements treatment regimen as prescribed by the Physician; assists the Physician during treatments and/or diagnostic procedures; keeps