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Experience in utilization review, concurrent review and/or risk management. In the Health and Social Services Manager role, you will lead a team of Health and Social Services Coordinators, while overseeing day-to-day clinical operations, in the state of New Jersey, and participating in business d...

NYMC #NYMCRegisteredNurse #NYhealthNewsletter #bronxrnsepad #BronxRNs2080019082 #BronxRNHybrid #BronxRNVidAd #NYMCRN #maxPriority #HighlightedJobs0827LI #HighlightedJobs0827FB. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, tra...

Required Qualifications:**+ Bachelor of Science in Nursing+ Current, unrestricted RN license in the State of residence+ 5+ years of recent experience in the inpatient acute setting+ 2+ years of experience of discharge planning+ Proficient in typing skills and software applications that includes, ...

Certified Home Health Agency (CHHA), Licensed Home Care Service Agency (LHCSA), Managed Long Term Care (MLTC), or experience in home care as a paraprofessional (e. Maximus is currently hiring hybrid remote Registered Nurse Assessors for the New York Independent Assessor Program, conducting UAS as...

Support an integrated care model tapping into appropriate resources both internally and external to the organization (Required). RN with current active RN license (Required). Support and enable members to manage their physical, environmental and psycho-social concerns, understand and appropriatel...

Registered Nurse (Hybrid Remote - Bronx, NY). Maximus is currently hiring hybrid remote Registered Nurse Assessors for the New York Independent Assessor Program, conducting UAS assessments to determine eligibility for community-based long-term services. NYMC #NYMCRegisteredNurse #NYhealthNewslett...

Provides telephonic case management to members, balancing clinical, social, and environmental concerns. Coordinates sharing of information between subcontractor Community Based Organizations (CBOs), DAC, and internal staff at VNS Health. Remote working/work at home options are available for this ...

Full time schedule available, with hybrid remote work setting. NYMC #NYMCRegisteredNurse #bronxrnsepad #LI-Hybrid #maxPriority #NYMCRN.

Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member by, for example: Assigning appropriate tasks to the non-RN clinicians, verifying and interpreting member information obtained by these ind...

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as...

Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member by, for example: Assigning appropriate tasks to the non-RN clinicians, verifying and interpreting member information obtained by these ind...

Maintains professional relationships with provider community, internal and external customers, and state agencies as appropriate, while identifying opportunities for improvement. NY RN, NY LMSE or NY LCSW licensure required. Registered Nurse or equivalent combination of Licensed Vocational Nurse ...

LTSS Service Coordinator - RN Telehealth. LTSS Service Coordinator - RN Telehealth.

Excellent interpersonal/ consensus building skills as well as the ability to work with a variety of internal and external colleagues from all levels of an organization. RN license in PA or WV or DE or NY is required. Other RN license(s), if applicable, must be obtained within the first 6 months o...

Assists in identifying opportunities for alternative care options based on member needs and assessments. Documents all encounters with providers, members, and vendors in the appropriate system in accordance with internal and established documentation procedures; follows up as needed; and updates ...

Identification of internal or community-based program support or resources. Assist with coordination of difficult cases needing placement in an alternate level of care facility. Current, unrestricted RN license in the State of residence.

The RN works under the direction of the provider, and activities are delegated to the RN by the provider or the Hub CSM. RN to APC Hand Off- One entry by the RN and one responding entry by the APC should be recorded in the appropriate documentation tool. Overnight and holidays are required for al...

About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. May review initial liability disability claims to determine extent and impact of insured's medical condition, medica...

Registered Nurse (RN) license in the state of New Jersey or a Compact RN License. We are seeking a highly skilled and compassionate Chronic Care Manager (RN) to join our team. This position offers the flexibility to work remotely.

Job Title: Case Manager (RN)Job Description. RN - Registered Nurse - State Licensure and/or Compact State Licensure. This is a fully remote position.

Must be proficient working with multiple computer systems independently, including Windows-based applications * Must have good clinical acumen with experience working with a variety of patients with acute and complex medical conditions * If an internal Cigna employee, CMs requ...

The Manager for Case Management services reports to the Case Management Director and is responsible for promoting patient-centered care by coordinating all aspects of hospital-based case management for his/her assigned area of responsibility in alignment with the goals of the Case Management Depa...

The regional alignment combines resources and services across the care continuum – from preventative medicine to diagnostics to treatment and beyond across New York, New Jersey, and Southern Connecticut. Experience in a remote work setting.

We are looking for a RN Care Review Clinician with Prior Authorization experience. Remote position with light travel- 10-15% for in person meeting at the Bronx office location. Must be able to travel within applicable state or locality with reliable transportation as required for internal meeting...