New York Licensed Clinical Evaluation Manager

A company is looking for a Clinical Evaluation Manager (Remote). Key Responsibilities Conducts comprehensive reviews of service requests, ensuring medical necessity and compliance with regulations Coordinates care management and develops patient-focused plans to facilitate safe transitions back into the community Maintains accurate records and provides input for improving department processes and procedures Required Qualifications Current license to practice as a Registered Professional Nurse or Occupational Therapist in New York State Associate's Degree in Nursing or a Master's Degree in Occupational Therapy required; Bachelor's or Master's Degree in Nursing preferred Minimum two years of experience in case management or acute inpatient hospital settings Knowledge of Medicare and Medicaid regulations required Experience working with the LTSS eligible population preferred

Apr 8, 2025 - 21:40

A company is looking for a Clinical Evaluation Manager (Remote). Key Responsibilities Conducts comprehensive reviews of service requests, ensuring medical necessity and compliance with regulations Coordinates care management and develops patient-focused plans to facilitate safe transitions back into the community Maintains accurate records and provides input for improving department processes and procedures Required Qualifications Current license to practice as a Registered Professional Nurse or Occupational Therapist in New York State Associate's Degree in Nursing or a Master's Degree in Occupational Therapy required; Bachelor's or Master's Degree in Nursing preferred Minimum two years of experience in case management or acute inpatient hospital settings Knowledge of Medicare and Medicaid regulations required Experience working with the LTSS eligible population preferred