- Registered Nurse with current license and registration and no disciplinary actions on
- Minimum five years of clinical experience
- Three (3) years investigative experience
- Computer skills to include basic word processing and database applications
- Excellent written and oral communication skills
- Good customer service skills
- Experience with the professional medical conduct process
- Responsible for investigating complaints and developing an investigative plan for cases
- Conduct telephone interviews of complainants and physicians.
- Coordinate with Medical Coordinators to review patient files to opine on standard of
- Draft correspondence to subjects of investigation in compliance with NYS PHL Section
- Obtain and review confidential data which may be necessary to locate subjects of
- Review and summarize all previous OPMC investigations of the subject physician.
- Document all investigative actions using the established OPMC protocol.
- Maintain the OPMC database iTrak to reflect all completed investigative actions.
- Prepare investigative summary of all actions including recommendation for disposition of
- Prepare correspondence to complainant and physician advising of disposition of case, as
- Prepare and present cases before Investigation Committee of the Board for Professional
- Respond to telephone calls from the public with questions concerning Section 230.
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Utilization Review Nurse
3 weeks ago
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC Albany, United StatesGrounded by a compelling mission, core values, and compassion for people, CDPHP and its family of companies offer a strong foundation for a rewarding career. Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that off ...
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Nursing Facility Resolution Reviewer
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IPRO Albany, United StatesBased in Albany, working at the direction of the NYS Department of Health (DOH) you will be primarily responsible for the day-to-day case management of Nursing Facility Quality of Care Complaints. As a Nursing Facility Resolution Reviewer you will interface with the resident &/or ...
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Nursing Facility Resolution Reviewer
1 week ago
IPRO Albany, United StatesBased in Albany, working at the direction of the NYS Department of Health (DOH) you will be primarily responsible for the day-to-day case management of Nursing Facility Quality of Care Complaints. As a Nursing Facility Resolution Reviewer you will interface with the resident &/or ...
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Nurse Reviewer
2 weeks ago
Public Consulting Group Albany, United StatesOverview · Nurse Reviewer - Quality Assurance in Albany, NY · Staffing Solutions Organization LLC (SSO), a wholly owned subsidiary of Public Consulting Group, is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a ...
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Nurse Reviewer
2 weeks ago
Public Consulting Group Albany, NY, United StatesOverview · Nurse Reviewer - Quality Assurance in Albany, NY · Staffing Solutions Organization LLC (SSO), a wholly owned subsidiary of Public Consulting Group, is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a ...
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Nurse Reviewer
2 weeks ago
Public Consulting Group Albany, NY, United States**Overview** · **Nurse Reviewer - Quality Assurance in Albany, NY** · Staffing Solutions Organization LLC (SSO), a wholly owned subsidiary of Public Consulting Group, is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is commit ...
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Utilization Review Nurse
2 days ago
Albany Medical Center New Scotland Avenue, United States43 New Scotland Avenue · Department/Unit: · Care Management/Social WorkWork Shift: · Day (United States of America)Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. · Salary: $65, $107,348.80 · • Completes Utilization Management ...
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utilization review nurse
2 weeks ago
Albany Medical Center Albany, NY , USA, United StatesDepartment/Unit: · Care Management/Social Work · Work Shift: · Day (United States of America) · Utilization Review Nurse · Salary Range: $ $51.61 per hour · Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. · Qualifications and ...
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Utilization Review Nurse
1 day ago
Albany Medical Center Albany, United States Full time43 New Scotland Avenue Albany, NY 12208 · Department/Unit: · Care Management/Social WorkWork Shift: · Day (United States of America)Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. · Salary Range: $ $51.61 per hour · • Complete ...
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Utilization Review Nurse
2 weeks ago
Albany Medical Center Albany, NY, United StatesDepartment/Unit: · Care Management/Social Work · Work Shift: · Day (United States of America) · Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. · Salary Range: $ $51.61 per hour · - Completes Utilization Management and Quality ...
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utilization review nurse
2 weeks ago
Albany Medical Center Albany, NY , USA, United StatesDepartment/Unit: · Care Management/Social Work · Work Shift: · Day (United States of America) · Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. · Salary: $65, $107,348.80 · - Completes Utilization Management and Quality Screen ...
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Nursing Facility Resolution Reviewer
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IPro Albany, NY, United StatesBased in Albany, working at the direction of the NYS Department of Health (DOH) you will be primarily responsible for the day-to-day case management of Nursing Facility Quality of Care Complaints. As a Nursing Facility Resolution Reviewer you will interface with the resident &/or ...
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clinical review and coding nurse
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Capital District Physicians' Health Plan, Inc. Albany, NY , USA, United StatesCDPHP and its family of companies are mission-driven organizations that support the health and well-being of our customers and the communities we are proud to serve. CDPHP was founded in Albany in 1984 as a physician-guided not-for-profit, and currently offers health plans in 29 ...
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Utilization Review Nurse
2 days ago
Albany Medical Center Slingerlands, NY, United StatesDepartment/Unit: · Care Management/Social WorkWork Shift: · Day (United States of America)Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. · Salary: $65, $107,348.80 · • Completes Utilization Management and Quality Screening fo ...
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Clinical Review Nurse
3 weeks ago
Centene Corporation Latham, United States Full timeYou could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. ...
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Associate Health Care Management Systems Analyst
2 weeks ago
Health, Department of Albany, United States**Minimum Qualifications** · Current NYS Department of Health (DOH) employee with permanent or contingent-permanent, competitive status as an Associate Health Care MSA, G-23 OR a NYS employee with one year or more of permanent or contingent-permanent, competitive service in a tit ...
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Nurse Practitioner
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MRG Exams Albany, United StatesWe are looking for the right Nurse Practitioner to perform medical assessments on United States Veterans as part of the VA's disability benefits process. · In performing Disability Assessments, you will review medical records electronically through a web portal and perform a focu ...
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Nurse Practitioner or Physician Assistant
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Rn Admission Facilitator
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St. Peter's Health Partners Albany, United States**Employment Type**: · Full time · **Shift**: · Day Shift · **Description**: · RN ADMISSION FACILITATOR · EDDY SKILLED NURSING FACILITIES (located at St. Peter's Hospital, Albany) · The Eddy's highly regarded Skilled Nursing Facilities have a unique opportunity for a RN to receiv ...
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Nurse Practitioner or Physician Assistant
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MRG Exams Albany, United StatesWork can be performed by a Nurse Practitioner or Physician Assistant · We are looking for the right Nurse Practitioner or Physician Assistant to perform medical assessments on United States Veterans as part of the VA's disability benefits process. · In performing Disability Asses ...
registered nurse reviewer - Menands, NY , USA, United States - New Wave People
Description
Albany NY
100% on site.
LONG TERM ASSIGNMENT
Salary Commensurate with Job Experience
Free Parking Provided
An estimated 10% travel is possible.
MINIMUM QUALIFICATIONS:
PREFERRED QUALIFICATIONS:
Knowledge of current investigative techniques
JOBS DUTIES AND RESPONSIBILITIES:
New Wave People is an Equal Opportunity Employer (EEO).
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