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Under general supervision of the Director of Case Management, the Utilization Review Nurse provides a clinical review of cases using medical necessity criteria to determine the medical appropriateness of inpatient and outpatient services.
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Provides referrals to Case Management, Disease Management, Appeals and Grievance and Quality Departments as necessary. Able to handle multiple tasks simultaneously while prioritizing cases to meet regulatory and business-based turnaround time.
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Experience with outpatient reviews including DME, Genetic Testing, Clinical Trials, Oncology, and/or elective surgical cases preferred. Provides referrals to Case management, Disease Management, Appeals & Grievances, and Quality Departments as needed.
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Conducting legal research to stay updated on changes in immigration laws, policies, and procedures, and applying this knowledge to client cases. Drafting legal documents, including visa applications, petitions, appeals, and responses to government inquiries.
$130,000 - $180,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Appeal Analyst RN who will train new hire in the clinical role to complete Utilization Management Appeals and act as an RN II on the team. · This position is responsible for handling all Utilization Management medical appeal cases.
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Prepare and argue difficult cases and appeals in administrative tribunals. Analyze the relative strength of impartial hearing cases and evaluate the appropriateness of plaintiffs demands.
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Each Staff Attorney participates in various legal program functions, including: (1) initial intake and in-depth evaluation of cases for representation; (2) participation at community legal clinics; (3) information and pro se services at the immigration courts; and (4) direct representation of NYC based clients, including adults, unaccompanied minors, and adults with children (AWC) in removal proceedings.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Harrison and Pai, PLLC handles a wide variety of immigration cases including both detained and non-detained removal defense, bond representation, family-based and employment-based immigrant petitions, business and employment visas, humanitarian relief (asylum, VAWA, U Visas), citizenship and naturalization, and appeals work.
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Minimum of two (2) years in managed care setting, Care Management, Utilization Management and/or Grievance and Appeals experience. The Clinical Utilization Registered Nurse works directly with the Clinical Utilization Director in supporting clinical decisions for hospital and skilled nursing admissions, decisions on Personal Care Aide services for high hour cases, and decisions for high dollar medical equipment.
$95,000 - $110,000 a yearFull-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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The Clinical Utilization Registered Nurse is responsible for collaborating with Care Management in order to support the defense of fair hearings, PCA high hour decisions, and MAP admissions. Pet Insurance Discount Plan.
Full-timeExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Must be a team player who will thrive in a collaborative environment, contributing to a diverse range of commercial disputes that include partnership law, employment matters, contract disputes, real estate issues, fraud cases, unfair competition claims, breaches of fiduciary duty, class actions, derivative litigation, and civil rights issues.
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You will work on a range of immigration cases including removal/deportation defense, appeals, federal court litigation, family-based immigration, employment-based immigration, waivers, asylum, and naturalization.
$24 - $30 an hourTemporaryExpandApply NowActive JobUpdated 20 days ago - UpvoteDownvoteShare Job
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Provide excellent, client-centered representation in an array of civil matters for clients in contact with the family policing system in the Bronx, including primarily in housing, public benefits, and shelter cases.
Full-timeExpandApply NowActive JobUpdated 25 days ago - UpvoteDownvoteShare Job
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The Immigrants' Rights/International Human Rights Clinic provides direct representation in matters including asylum and Convention Against Torture claims, deferred action labor enforcement (DALE) petitions, human trafficking and VAWA cases, detained and non-detained cases before immigration judges, and appeals at the Board of Immigration Appeals and the Third Circuit.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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You will work to negotiate settlements, prepare cases for trial, and champion the client's interests in the courtroom. Experience in all phases of litigation, including trial, negotiation, and appeals.
$150,000 - $175,000 a yearFull-timeExpandApply NowActive JobUpdated 7 days ago
appeals cases jobs in New York, NY
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