Clinical Utilization Management Nurse

Job OverviewMEDNATIONAL is seeking an experienced Utilization Management (UM) Nurse to join our team. This role involves assessing healthcare services to ensure optimal patient outcomes and compliance with regulatory standards.Key Responsibilities:Service Assessment and Compliance: Evaluate healthcare services to guarantee optimal patient outcomes and...

Cynet Health is seeking a highly skilled Care Manager to join their team in the Emergency Department (ED) for a 9-month contract. This role requires strong leadership experience, excellent clinical expertise, and proficiency in utilization review and care coordination.Key Responsibilities:The successful candidate will be responsible for performing...

We're offering an exciting opportunity for a talented Utilization Management Nurse to join our team at Metropolitan Jewish Health System. As a Utilization Management Nurse, you'll be responsible for reviewing and processing requests for services to ensure they align with established guidelines and regulations.Key ResponsibilitiesProcess all requests for...

Role SummaryWe are seeking a skilled Medical Documentation Specialist to join our clinical team in New York City. This role is ideal for an experienced professional looking to leverage their expertise in clinical documentation improvement.Our hospital network is committed to providing world-class care and innovative solutions in healthcare management. As a...

OverviewAt MJHS, we are dedicated to providing exceptional healthcare services to our patients and members. Our team of professionals works collaboratively to ensure that our health plans meet the needs of our diverse population.In this role as a Managed Care Nurse - Utilization Review Specialist, you will play a critical part in reviewing cases and...

Job Summary:SUNY Downstate Health Sciences University's Department of Care Management is seeking an experienced Utilization Review Nurse Specialist to support the review and management of patient care services.Key Responsibilities:* Complete and send initial clinical reviews within 48 hours of admission to payors via Care Management Module, CarePort.*...

Job OverviewMJHS Health System is a leading provider of healthcare services, dedicated to delivering high-quality care to our patients and members. As a Pre-Authorization Nurse at MJHS, you will play a critical role in ensuring that our patients receive the best possible care, while also contributing to the growth and development of our health plans.About...

**Job Overview**EmblemHealth seeks a highly skilled Clinical Coordination Manager to oversee the coordination of home infusion services. The ideal candidate will have 5-10+ years of clinical experience in a managed care setting, preferably including acute care experience.**Key Responsibilities:**Provide short-term care coordination with members, physicians,...

Job OverviewTandym Group is seeking an experienced Clinical Nursing Manager to lead our ambulatory care team in Manhattan, New York City.About the OpportunityStart Date: ASAPAssignment Length: Ongoing (Contract to Hire)Schedule: Monday to Friday (1 Saturday per month)Hours: 8am to 6pm (Mon & Wed); 8am to 5pm (Tues, Thurs, Fri); 8am to 4pm...

About the RoleWe are seeking a highly skilled Clinical Nurse Manager to join our OB/GYN department at Weill Cornell Medical College. As a key member of our team, you will be responsible for managing the delivery of patient care and supervising a team of clinical assistants.ResponsibilitiesMaintain and update clinical policies and procedures manuals, ensuring...

Job OverviewWe are seeking a dedicated RN Case Manager to join our team at Open Systems Technologies in New York.About the RoleThis is a pivotal opportunity for a registered nurse to utilize their clinical expertise and strong communication skills in a case management setting. As an RN Case Manager, you will play a critical role in ensuring seamless care...

About UsMJHS Health System is a leading provider of healthcare services, dedicated to delivering high-quality care to our patients and members. Our team of experts works collaboratively to ensure that our patients receive the best possible care.Salary and BenefitsThe salary for this position is estimated at $95,000 per year, with opportunities for career...

**Clinical Magnet Partnership**We are excited to partner with a leading healthcare organization to find the next Director of Nursing for one of their surgery center locations in the Manhattan, NY area.This is a direct hire opportunity, offering a unique chance to lead all aspects of the nursing department, overseeing OR, Preop, and PACU, while driving...

Job OverviewMetroPlusHealth is a leading healthcare provider in New York, committed to delivering high-quality services to residents across the city. We are seeking an experienced Clinical Compliance Audit Manager to join our team.About the RoleThe Clinical Compliance Audit Manager will be responsible for leading monitoring and auditing activities of...

Cynet Health is seeking a highly skilled Clinical Care Manager to join our team in New York. As a Clinical Care Manager, you will play a critical role in coordinating and managing patient care in a long-term care setting.Job SummaryThis is an exciting opportunity for a seasoned Registered Nurse with leadership experience to leverage their skills and...

The MJHS team is committed to providing high-quality healthcare services to our patients and members.Salary: $85,000 - $110,000 per yearAbout UsAt MJHS, we believe that everyone deserves access to affordable and quality healthcare. Our Medicare and Medicaid managed care health plans are designed to help keep people independent and living life on their own...

At the New York State Office of Mental Health, we are seeking a skilled Healthcare Utilization Specialist to join our team.Job OverviewThe selected candidate will work with us to analyze and evaluate quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness. This role is responsible for...

Albany Medical Center seeks a skilled Clinical Education Specialist to join our team.About the RoleThe ideal candidate will have a Master's degree in Social Work, Nursing, or Education and significant experience in Clinical Social Work or Nursing, with expertise in Case Management, Utilization Review, and Discharge Planning. As a seasoned professional,...

Compass Healthcare Consulting and Placement is seeking a seasoned Registered Nurse to lead the Case Management Department at one of our esteemed clients in the Bronx, NY. This is an exciting opportunity for a healthcare professional to make a meaningful impact on patient care outcomes while working collaboratively with a team of clinical staff and healthcare...

Patient CareDelivers patient care by incorporating the tenets of the professional practice model of Relationship Centered Care and through the application of the nursing process based upon theory, research, evidence-based practice, and approved organizational nursing standards.Assesses and evaluates patient care needs and applies critical thinking skills in...