Current jobs related to Um Care Review Clinician Inpatient Review - Bronx - Molina Healthcare
-
Chief Psychiatrist
2 weeks ago
Bronx, New York, United States Physician Affiliate Group of New York Full timeJob SummaryWe are seeking a highly skilled and experienced Chief Psychiatrist to lead our Inpatient Psychiatry Unit at Physician Affiliate Group of New York. As a key member of our team, you will be responsible for overseeing the daily operations of the unit, collaborating with interdisciplinary treatment teams, and providing direct patient care.Key...
-
Rheumatologist Clinician Educator
6 days ago
Bronx, New York, United States Physician Affiliate Group of New York Full timeSeeking a Rheumatologist Clinician EducatorWe are seeking a highly skilled Rheumatologist Clinician Educator to join our team at the Department of Medicine at the Jacobi Medical Center and North Central Bronx Hospital in the Bronx, NY.About the RoleThe Division of Rheumatology is an academic practice sponsored by the Albert Einstein College of Medicine and...
-
Rheumatologist Clinician Educator
2 days ago
Bronx, New York, United States Physician Affiliate Group of New York Full timeSeeking a Rheumatologist Clinician EducatorWe are seeking a highly skilled Rheumatologist Clinician Educator to join our team at the Department of Medicine at the Jacobi Medical Center and North Central Bronx Hospital in the Bronx, NY.About the RoleThe Division of Rheumatology is an academic practice sponsored by the Albert Einstein College of Medicine and...
-
Rheumatologist Clinician Educator
2 weeks ago
Bronx, New York, United States PAGNY Full timeJob SummaryPAGNY is seeking a full-time Rheumatologist Clinician Educator to join the Department of Medicine at the Jacobi Medical Center and North Central Bronx Hospital (NCB) in the Bronx, NY.About the RoleThe Division of Rheumatology is an academic practice sponsored by the Albert Einstein College of Medicine (AECOM) and supported by the Montefiore...
-
Licensed Mental Health Clinician
1 week ago
Bronx, United States Vocational Instruction Project Community Services Inc. Full timeJob Title: Licensed ClinicianVocational Instruction Project Community Services Inc. is seeking a skilled Licensed Clinician to join our team.Job SummaryWe are looking for a highly motivated and experienced Licensed Clinician to provide individual and group counseling services to individuals diagnosed with an Opioid Use Disorder. The successful candidate will...
-
Senior Mental Health Clinician
2 days ago
Bronx, New York, United States Services for the UnderServed Full timeJob SummaryWe are seeking a highly skilled Senior Mental Health Clinician to join our team at Services for the UnderServed. As a key member of our care transition team, you will work closely with patients, families, and healthcare providers to ensure a seamless transition from hospital to community-based care.Key ResponsibilitiesConduct comprehensive...
-
Rheumatologist Clinician Educator
2 weeks ago
Bronx, New York, United States Physician Affiliate Group of New York Full timeJob SummaryWe are seeking a highly skilled Rheumatologist Clinician Educator to join our team at Physician Affiliate Group of New York. As a key member of our Department of Medicine, you will be responsible for providing exceptional patient care, teaching and mentoring medical students, residents, and fellows, and contributing to the development of our...
-
Inpatient Care Physician
4 weeks ago
Bronx, New York, United States MONTEFIORE MEDICAL CENTER Full timePosition Title: Inpatient Care Physician - Weiler CampusLocation: Weiler Campus, Department of Emergency MedicineCompensation: $250,000 annually plus performance incentivesPosition Overview:We are in search of dedicated and qualified candidates who are Board Eligible/Board Certified in Internal Medicine or Family Medicine to join our team as Inpatient Care...
-
Chief Psychiatrist
6 days ago
Bronx, New York, United States Physician Affiliate Group of New York Full timeChief Psychiatrist - Inpatient Unit DirectorPhysician Affiliate Group of New York (PAGNY) is seeking a highly skilled and experienced Chief Psychiatrist to lead our Inpatient Psychiatry Unit. As a key member of our team, you will be responsible for overseeing the daily operations of the unit, collaborating with interdisciplinary treatment teams, and...
-
Rheumatologist Clinician Educator
2 weeks ago
Bronx, New York, United States Physician Affiliate Group of New York Full timeAbout the RoleWe are seeking a highly skilled Rheumatologist Clinician Educator to join our team at Physician Affiliate Group of New York. As a key member of our Department of Medicine, you will be responsible for providing exceptional patient care, teaching and mentoring medical students, residents, and fellows, and contributing to the development of our...
-
Rheumatology Clinician Educator Position
2 weeks ago
Bronx, New York, United States Integrity Healthcare Full timeJob Summary:We are seeking a highly skilled and experienced Rheumatologist to join our team as a Clinician Educator at the Assistant or Associate Professor level. As a key member of our Division of Rheumatology, you will be responsible for providing clinical care to patients, teaching and mentoring medical students, residents, and fellows, and participating...
-
Student Assistant
4 months ago
Bronx, United States Albert Einstein College of Medicine Full timePOSITION RESPONSIBILITIES Reporting to the Education Facilities Manager for the Office of Medical Education, the student will ensure that the classrooms are clean and presentable for class each day. They will check that the air conditioning/heating, clocks, lights, and technology are all in working order. They will replace all the markers and...
-
Rheumatology Clinician Educator
2 days ago
Bronx, NY, United States Montefiore Medical Center Full timeJob OpportunityWe are seeking a highly skilled Rheumatology Clinician Educator to join our team at Montefiore Medical Center. As a key member of our Division of Rheumatology, you will play a vital role in providing exceptional patient care, teaching, and research opportunities.Key ResponsibilitiesProvide consultative services in our multi-specialty...
-
Full Time Wound Care Physician
4 months ago
Bronx, United States TeamHealth Full timeDeliver compassionate patient care as a part-time wound care physician for our post-acute facility in the Bronx, New York. We have facilities in all five boroughs and into Westchester County. Work alongside our primary care team to provide the best possible care to patients. We have a strong team that has been together for over 20 years. Inpatient experience...
-
Orthopedic Department Assistant
7 days ago
Bronx, New York, United States BronxCare Health System Full timeJob SummaryWe are seeking a highly skilled Physician Assistant to join our Orthopedic department at BronxCare Health System. The successful candidate will have comprehensive responsibilities to manage and assist in various areas of inpatient surgery, major joint replacement, and spine care.Key ResponsibilitiesPerform initial Orthopaedics evaluations in the...
-
Physician Assistant
2 days ago
Bronx, New York, United States BronxCare Health System Full timeJob SummaryWe are seeking a highly skilled Physician Assistant to join our Orthopedic Department at BronxCare Health System. The successful candidate will be responsible for managing and assisting in various aspects of patient care, including inpatient surgery, peri-operative care, and outpatient evaluations.Key ResponsibilitiesPerform initial Orthopedic...
-
Physician Assistant
1 day ago
Bronx, New York, United States BronxCare Health System Full timeJob SummaryWe are seeking a highly skilled Physician Assistant to join our Orthopedic Department at BronxCare Health System. The successful candidate will be responsible for managing and assisting in the areas of inpatient surgery, major joint replacement and spine, peri-operative care, surgical preparation, and outpatient evaluations.Key...
-
Senior Mental Health Clinician
1 week ago
Bronx, New York, United States Services For The Underserved, Inc. Full timeJob SummaryWe are seeking a highly skilled Senior Mental Health Clinician to join our team at Services For The Underserved, Inc. This role will involve working with mentally ill inpatients at Bronx Psychiatric Center, addressing their preparatory needs, and developing daily living skills through group and individual work.Key ResponsibilitiesConduct needs...
-
Physical Therapist Assistant
5 days ago
Bronx, New York, United States Mitchell Martin Full timeJob SummaryWe are seeking a skilled Physical Therapist Assistant to join our team at Mitchell Martin. As a Physical Therapist Assistant, you will provide direct patient care in inpatient and outpatient areas, managing patients with physical disabilities due to illness or injury.Key ResponsibilitiesImplement individualized treatment plans under the direct...
-
Family Medicine Physician
3 weeks ago
Bronx, New York, United States UnitedHealth Group Full timeJob SummaryWe are seeking a dedicated Family Medicine Physician to join our team at Optum Tri-State, a collaboration of Riverside Medical Group, CareMount Medical, and ProHealth Care. As a member of our interdisciplinary care group, you will play a crucial role in providing high-quality patient care and contributing to the well-being of our community.Key...
Um Care Review Clinician Inpatient Review
3 months ago
Job Summary
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
We are seeking a Registered Nurse with UM and Inpatient Review experience. The Care Review Clinician must be able to work independently in a high-volume environment. Further details to be discussed during our interview process.
Remote position in New York.
Work schedule Monday - Friday 8:30 AM to 5:00 PM EST with r otating weekend and holiday coverage
- 2 hour shifts.
KNOWLEDGE/SKILLS/ABILITIES
Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed.
Processes requests within required timelines.
Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner.
Requests additional information from members or providers in consistent and efficient manner.
Makes appropriate referrals to other clinical programs.
Collaborates with multidisciplinary teams to promote Molina Care Model.
Adheres to UM policies and procedures.
Occasional travel to other Molina offices or hospitals as requested, may be required. This can vary based on the individual State Plan.
JOB QUALIFICATIONS
Required Education
Graduate from an Accredited School of Nursing.
Required Experience
3+ years hospital acute care/medical experience.
Required License, Certification, Association
Active, unrestricted State Registered Nursing (RN) license in good standing.
Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
NY RN Licensure
**State Specific Requirements**:
Preferred Education
Bachelor's Degree in Nursing
Preferred Experience
Recent hospital experience in ICU, Medical, or ER unit.
UM Experience
Preferred License, Certification, Association
Active, unrestricted Utilization Management Certification (CPHM).
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
**Pay Range**: $23.76 - $51.49 / HOURLY
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
