Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding servic…
Skills: Clinical Appeals, Grievance Management, Utilization Management, Case Management, Evidence Based Practice
Description To perform radiographic examinations on patients referred by physicians in accordance with Radiology protocols. Responsibilities Performs Specialized procedures. Performs CT Scan procedures. Operates all radi…
Grand Central/Prelude Applications Analyst II-Digital and Technology Partners- Remote
New York, New York, United States · Remote OK
$82k–$123k/yr
Mid level
Description The Applications Analyst II designs and specifies information systems solutions to address business needs and the methods for installing them. Responsibilities 1. Works with client management to identify and …
Skills: Grand Central, Prelude, Systems Design, Business Requirements, Systems Testing
Mount Sinai Health Systems
System Director-Mount Sinai Hospital - Emergency Management Training and Education
New York, New York, United States · On-site
$117k–$208k/yr
Senior+
Description The System Director is responsible for the development, implementation, and management of the Health System’s comprehensive emergency management education, training, and exercise programs. The System Director…
Skills: Emergency Management, Training And Education, Leadership, Strategic Planning, Program Management
The gap no one has filled Every complex system in America has a profession whose job it is to be your trusted guide. A lawyer for legal. An accountant for taxes. A financial advisor for your money. Healthcare, a trillion…
Skills: Clinical Leadership, Care Model Design, Medical Direction, Geriatric Care, Clinical Oversight
Mount Sinai Health Systems
Clinical Nurse-Mount Sinai Hospital- Full Time- Days- Neuro ICU
New York, New York, United States · On-site
$64/hr–$64/hr
Mid level
Description The Clinical Nurse is a Registered Professional Nurse who provides safe, competent quality care based on nursing theory and research to a designated group of patients and significant others. Responsibilities …
Skills: Critical Care Nursing, Neurological Assessment, Patient Monitoring, Intensive Care Unit Protocols, Patient Advocacy
Mount Sinai Health Systems
Clinical Nurse-Mount Sinai Hospital- Part Time- Days- SICU 3039677
New York, New York, United States · On-site
$64/hr–$64/hr
Entry level
Description The Clinical Nurse is a Registered Professional Nurse who provides safe, competent quality care based on nursing theory and research to a designated group of patients and significant others. Responsibilities …
Outreach Program Coordinator (Part-Time)- Div Gen Int Medicine
New York, New York, United States · On-site
$30/hr–$32/hr
Entry level
Description The Outreach Program Coordinator is responsible for assisting in the development and dissemination of inclusive promotional and educational materials tailored to the needs of the grant's target communities, E…
Skills: Community Outreach, Patient Coordination, Scheduling, Insurance Verification, Referrals Management
Mount Sinai Health Systems
Clinical Nurse (PTO)-MSH/SSVS-Neurosurgery
New York, New York, United States · On-site
$64/hr–$64/hr
Entry level
Description The Clinical Nurse is a Registered Professional Nurse who provides safe, competent quality care based on nursing theory and research to a designated group of patients and significant others. Responsibilities …
Outreach Program Coordinator (Part-Time)- Div Gen Int Medicine
New York, New York, United States · On-site
$30/hr–$32/hr
Entry level
Description The Outreach Program Coordinator is responsible for assisting in the development and dissemination of inclusive promotional and educational materials tailored to the needs of the grant's target communities, E…
Skills: Outreach coordination, Patient guidance, Community engagement, Scheduling, Insurance verification
Mount Sinai Health Systems
Staff Nurse - Pediatric Vascular Access Team - Mount Sinai Hospital - Part Time Nights
New York, New York, United States · On-site
$64/hr–$64/hr
Mid level
Description The Clinical Nurse is a Registered Professional Nurse who provides safe, competent quality care based on nursing theory and research to a designated group of patients and significant others. Responsibilities …
Nursing Attendant - Ambulatory Surgery - Mount Sinai Morningside - Full Time - Days - 5:30am - 1:30pm
New York, New York, United States · On-site
$24/hr–$26/hr
Entry level
Description Nursing Attendant - Ambulatory Surgery - Mount Sinai Morningside - Full Time - Days - 5:30am - 1:30pm The Nursing Attendant is an individual who functions in a support role to the Registered Professional Nurs…
Skills: Patient care, Vital signs monitoring, Patient transport, Activities of daily living assistance, Infection control
Mount Sinai Health Systems
Postdoctoral Fellow-MSH-12910-025
New York, New York, United States · On-site
$73k–$80k/yr
Entry level
Description Postdoctoral Fellowship in Neuropsychology Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai Overview A full-time Neuropsychology Postdoctoral Fellowship position is available wit…
Porter Building-BI-Housing and Transportation -Full Time/Days (8am-4:30pm)/Tues-Sat
New York, New York, United States · On-site
$32/hr–$32/hr
Entry level
Description Porter- Housing and Transportation Performs a variety of cleaning and housekeeping duties for MSMC Residential Realty buildings and is responsible for the overall cleaning of apartments and commons areas. Res…
Skills: Cleaning, Housekeeping, Building maintenance, Appliance cleaning, Waste management
Mount Sinai Health Systems
Per Diem Radiologic Technologist-Mount Sinai West- Saturday 8am-4pm
New York, New York, United States · On-site
$50/hr–$50/hr
Entry level
Description To perform radiographic examinations on patients referred by physicians in accordance with Radiology protocols Responsibilities 1. Performs routine radiological procedures. 2. Applies the necessary technical …
Medical Office Specialis - 10:45 - 7pm with Saturdays (45 Rivington coverage if needed)
New York, New York, United States · On-site
$32/hr–$33/hr
Mid level
Description The Medical Office Specialist offers clinical and medical office support to physicians and surgeons. Assists in patient care and administrative duties necessary to deliver quality patient care. Performs vario…
Skills: Patient care, Phlebotomy, Vital signs monitoring, Electronic medical record, Medical terminology
Company Description It all started when engineer Fred Luddy wrote code that automated a tedious task for his coworker, Phyllis. She cried tears of joy. That moment inspired Fred to build a company that could do that for …
Skills: Industry Marketing, Product Marketing, Go-To-Market Strategy, Positioning, Life Sciences Expertise
Bilingual English / Cantonese / Mandarin Service Account Manager Associate
New York, New York, United States · On-site
$20/hr–$36/hr
Mid level$7.6B raised
This position is Onsite. Our office is located at 161 Canal St. New York, NY and 136-02 Roosevelt Ave Flushing NY 11354. Imagine being able to get answers to your health plan questions from someone who speaks the same la…
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$110k–$120k/yr
Full-time
bachelor degree
Sign-on Bonuses, Student Loan Assistance, MSN in Education, Tuition Reimbursement, Dependent Tuition Reimbursement, Paid Time Off
Posted 34d ago
Apply by Jul 7
~40 hrs/week
Responsibilities
The RN Coordinator investigates and responds to clinical appeals and grievances from members and providers. This role ensures compliance with Elderplan Contract Benefits, CMS, and DOH regulations.
Requirements
Requires a graduate of an accredited nursing program with a New York State nursing license and a BSN preferred. Candidates must have at least 2 years of clinical experience and 2 years of managed care or hospital-based utilization/case management experience.
Full job description
Overview
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
The MJHS Difference
At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.
Benefits include:
Sign-on Bonuses OR Student Loan Assistance for clinical staff
Free MSN in Education program!
Tuition Reimbursement for all full and part-time staff
Dependent Tuition Reimbursement for clinical staff!
Generous paid time off, including your birthday!
Affordable and comprehensive medical, dental and vision coverage for employee and family members
Two retirement plans! 403(b) AND Employer Paid Pension
Flexible spending
And MORE!
MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)
Responsibilities
The RN Coordinator will investigate and respond to written and/or verbal clinical appeals, expedited clinical grievances and potential quality of care grievances submitted by members and providers in accordance with Elderplan Contract Benefits, CMS (Centers for Medicare & Medicaid Services), and DOH (Department of Health) regulations.
Qualifications
Graduate of accredited nursing program; BSN preferred
2 years managed care or hospital based ulilization/case management experience
2 years minimum clinical experience
Licensed nurse in New York State
Proficiency with Microsoft Word, Excel, Power Point and Outlook is required
Must have excellent written ad verbal communication skills
Must be comfortable researching current evidence based practice guidelines and protocols
Must be able to multi-task and managed multiple projects efficiently, meet deadlines, demonstrate analytical/critical thinking skills, and provide excellent customer services that leads to positive problem resolution
Min
USD $110,000.00/Yr.
Max
USD $120,000.00/Yr.
Related keywords
Managed Care NursingCMSDOHClinical AppealsGrievancesUtilization ManagementCase ManagementBSNRN LicenseEvidence Based PracticeMedicareMedicaidElderplanHealthcare Compliance
MJHS is a large not-for-profit health system in the Greater New York area.
Our range of health services include home care, hospice and palliative care for adults and children, rehabilitation and nursing care at Menorah and Isabella Centers, and the research based MJHS Institute for Innovation and Palliative Care.
As a not-for-profit organization, many of our programs and services are made possible through the generosity of grateful families, corporate donors and grants, as well as our own employees.
Offices: 55 Water Street, New York, New York 10041, US · 39 Broadway, Third Floor, New York, NY 10006, US · 39 Broadway, Second Floor, New York, NY 10006, US · 1516 Oriental Blvd, Brooklyn, NY 11235, US · 6323 Seventh Avenue, Brooklyn, NY 11220, US
Home CareHealth PlansPalliative CareHospiceNursing HomePalliative Care ResearchRehabilitationNursing CarePhysical TherapyOccupational Therapy
How many Healthcare jobs are open in New York, NY right now?
There are currently 11,590 open healthcare positions in New York, NY listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Healthcare roles in New York, NY?
Companies currently hiring include Mount Sinai Health System, Northwell Health, New York City Housing Authority (NYCHA), CVS Health, NewYork-Presbyterian Hospital, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Healthcare jobs in New York, NY?
Yes — 2455 of the 11590 open healthcare positions offer remote or hybrid work (558 remote, 1897 hybrid).
How do I apply for Healthcare jobs in New York, NY?
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