Utilization review jobs in Forest Hills, NYCreate job alerts

Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Bronx, New York. Posted job title: Case Management (Utilization Review). Some of the industry-leading benefits enjoyed by Medical Solutions travel nurses and travel allied healthcare profes...

Minimum of two (2) years utilization review/case management experience or social work experience.

Associate degree in healthcare related filed. Bachelors or Masters Degree in related healthcare field (such as respiratory therapy or social work) may be considered. Minimum of two (2) years utilization review/case management experience or social work experience.

Minimum of two (2) years utilization review/case management experience or social work experience.

Minimum of two (2) years utilization review/case management experience or social work experience.

Minimum of two (2) years utilization review/case management experience or social work experience.

Our recruiters act not only as your dedicated travel career mentor but also become your number one advocate. License, travel, tuition, and scrub reimbursement. This means you get priority access to apply to travel and local assignments before other applicants.

Host Healthcare is an award-winning travel healthcare company with an immediate opening for this. At Host Healthcare, we are dedicated to empowering the life and healthcare career you deserve. TravelNurseSource is working with Host Healthcare to find a qualified Case Manager RN in Syracuse, New Y...

TravelNurseSource is working with Host Healthcare to find a qualified Case Manager RN in Bronx, New York, 10457!.Host Healthcare is an award-winning travel healthcare company with an immediate opening for this.Passionate and transparent team members have made Host Healthcare the agency of choice ...

TravelNurseSource is working with LRS Healthcare to find a qualified Case Manager RN in White Plains, New York, 10601!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24/7 support, and a responsive, traveler-first culture.What are you waiting for? Apply t...

Registered Nurse Clinical Reviewer / IDR - Lake Success, NY (#25154 B) Minimum of 1-3 years of experience in utilization review/appeals background Greenlife Healthcare Staffing is currently seeking a ...

Conduct Utilization review via Chart Review. * Conduct timely concurrent reviews and responses to third party payors request for clinical reviews. * Work collaboratively with ED Case Managers and ...

Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift and mid shift Job types available: full time and part time Employer features: Academic medical center, Cross training ...

Coordinate with Utilization Management (UM) department on concurrent and retrospective review. Follow up with assigned nurses for clinical updates to care plan. Document within two business day ...

Actively participates in Quality Assurance/Performance Improvement and Utilization Review activities. * Conducts medical records audits, participates in needs analyses, oversees new/revised practices ...

Utilization Management * Participate in utilization review and management. * Maintain focus on key strategic priorities including patient experience, access to care, increased market share, and ...

The Case Manager is responsible for all aspects of discharge planning and utilization management/review for an assigned group of patients to determine the appropriateness of the admission and ...

A minimum of two years experience performing utilization review, claims adjudication, medical review, fraud investigation, surveillance or monitoring activities, required; OR * Three years of ...

Participate in Utilization reviews and remaining available for emergency consultations. • Analyze the best medications or therapy treatment to help patient maximize quality of life. * Maintain ...

Assess appropriate site of care utilization and continued medical necessity reviews for prior authorization to vendors. * Ensure communication with MD offices in relation to Site of Care program

The position also involves reviewing outcomes, coding, and utilization data to enhance participant health and reduce unnecessary utilization. Benefits * Medical, Vision, Dental, and Life Insurance

Coordinate with Utilization Management (UM) department on concurrent and retrospective review. * Follow up with assigned nurses for clinical updates to care plan. * Document within two business day ...

... to ensure optimal utilization of services. * Ensure quality standards set by the external ... Provide ongoing review of emergency equipment, biological and medications in order to maintain ...

Documents learning outcomes of patient/family and revises education plan Include utilization of EHR ... Engages in self assessment and peer review; utilizes resources to meet individual learning need and ...