CrawlJobs Logo

A&G RN Coordinator

mjhs.org Logo

MJHS

Location Icon

Location:
United States , New York

Category Icon
Category:
Nursing

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

110000.00 - 120000.00 USD / Year
Save Job
Save Icon
Apply Position

Job Description:

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.

Job Responsibility:

  • 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
  • Determines types of reconsiderations, redeterminations, action appeals, grievances, and grievance appeal
  • Investigation of Provider, Subscriber, Membership and Pharmacy Appeals to include: Reimbursement, Coding, Benefits, Pre-existing Conditions, Prior Approval, Medical Necessity, Precertification, Continued Stay, Reduction, Termination, and Suspension of services
  • Investigate and respond to written and/or verbal appeals and grievances submitted by members and providers in accordance with Elderplan Contract Benefits, CMS, and DOH regulations
  • Documents all relevant information in the Appeals and Grievances determination process in the appropriate designated areas
  • Tracks departments’ compliance with requested action as a component of the Appeals and Grievances determination process
  • Presents cases to Appeals & Grievances File Review
  • Attend and represent A&G at NYS Fair Hearings/OTDA/ALJ Hearing as required

Requirements:

  • Graduate of accredited nursing program
  • BSN preferred
  • 2 years managed care or hospital based utilization/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 and 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
What we offer:
  • Sign-on Bonuses OR Student Loan Assistance for clinical staff
  • FREE Online RN to BSN and MSN degree programs
  • 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

Additional Information:

Job Posted:
March 04, 2026

Employment Type:
Fulltime
Work Type:
On-site work
Icon
MJHS - All Job Offers
Job Link Share:
Copy Link Icon
Facebook Icon Twitter Icon LinkedIn Icon

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for A&G RN Coordinator

New

Private Duty Registered Nurse (Rn) - G-Tube / Trach / Vent Baby

Aveanna is compassion and passion rolled into one inspired purpose. It’s anythin...
Location
Location
United States , Crouse
Salary
Salary:
30.00 - 33.00 USD / Hour
aveanna.com Logo
Aveanna Healthcare
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Must have eligible good-standing license (RN) for the state in which the clinician will practice
  • Current CPR certification
  • Must be comfortable providing in-home nursing care to infants, children, adolescents, and adults
Job Responsibility
Job Responsibility
  • Execution of physician’s prescribed plan of care and compliant documentation of care in system of record
  • Administration of prescribed medication, treatments, and therapies
  • Patient assessments and coordination of care
  • Health, promotion, teaching, and training of family members
What we offer
What we offer
  • Health, Dental, Vision, and Life Insurance
  • Paid Time Off Available
  • 401(k) Savings Plan with Employer Matching
  • Paid training and ongoing professional development
  • Referral Bonuses
  • Nationwide footprint offers advancement and development opportunities
  • Competitive Weekly Pay
  • State-of-the-art technology allowing electronic charting at point of care
  • Flexible shifts and scheduling (8, 12, or 16-hour shifts
  • days/nights/weekends available)
  • Fulltime
Read More
Arrow Right
New

Private Duty Registered Nurse (RN) - G-Tube / Trach / Vent Baby

Aveanna is compassion and passion rolled into one inspired purpose. It’s anythin...
Location
Location
United States , Crouse
Salary
Salary:
30.00 - 33.00 USD / Hour
aveanna.com Logo
Aveanna Healthcare
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Must have eligible good-standing license (RN) for the state in which the clinician will practice
  • Current CPR certification
  • Must be comfortable providing in-home nursing care to infants, children, adolescents, and adults
  • Pediatrics experience is helpful, but not necessary
Job Responsibility
Job Responsibility
  • Execution of physician’s prescribed plan of care and compliant documentation of care in system of record
  • Administration of prescribed medication, treatments, and therapies
  • Patient assessments and coordination of care
  • Health, promotion, teaching, and training of family members
What we offer
What we offer
  • Health, Dental, Vision, and Life Insurance
  • Paid Time Off Available
  • 401(k) Savings Plan with Employer Matching
  • Paid training and ongoing professional development
  • Referral Bonuses
  • Nationwide footprint offers advancement and development opportunities
  • Local/community cases allow us to match you to a case that’s close to home
  • 1-on-1 Personalized Care
  • 24/7 clinical and operational support for direct clinical, plus scheduling assistance
  • Competitive Weekly Pay
Read More
Arrow Right

Charge Nurse

Charge Nurse – Pediatric Unit. Location: Chicago, Illinois. Organization Type: P...
Location
Location
United States , Chicago
Salary
Salary:
75000.00 - 95000.00 USD / Year
bhsg.com Logo
Beacon Hill
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Active Registered Nurse (RN) license in Illinois and graduation from an accredited RN program
  • Minimum 2+ years of pediatric nursing experience, including complex pediatric care
  • At least 3 years of supervisory or charge nurse experience overseeing clinical staff
  • Current CPR certification with strong clinical competencies (e.g., trach care, G-tube feedings, CVL care)
Job Responsibility
Job Responsibility
  • Supervise and coordinate all nursing service activities and patient care on the assigned pediatric unit
  • Serve as a clinical resource and mentor to nursing staff, supporting orientation, training, and performance management
  • Ensure patient safety, infection control compliance, and high standards of quality care at all times
  • Perform and oversee comprehensive patient assessments, care planning, and accurate clinical documentation
  • Manage staffing assignments based on patient acuity and coordinate coverage, including on-call support
  • Oversee admissions and discharges, ensuring accurate transcription and execution of physician orders
  • Foster a collaborative, team-oriented environment focused on patient advocacy and family-centered care
  • Fulltime
Read More
Arrow Right

Licensed Practical Nurse

Are you looking for a job with flexibility AND variety? At LifeStyle Options you...
Location
Location
United States , Des Plaines
Salary
Salary:
28.00 USD / Hour
arcadiahomecare.com Logo
Arcadia Home Care and Staffing - an Addus family company
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Graduate from an accredited school of practical nursing
  • Licensed as a vocational/practical nurse in the state of practice
  • CPR Certification
  • Ability to provide nursing care in the home environment
  • Ability to complete necessary documentation appropriately, legibly and timely
  • Interpersonal, verbal and written communication skills necessary to complete job responsibilities
Job Responsibility
Job Responsibility
  • Perform selected nursing procedures, commensurate with experience and education within the scope of LVN/LPN practice including but not limited to: tracheostomy care, colostomy care and g-tube care
  • Provide client and family teaching according to plan outlined by the RN
  • Monitor client’s vital signs and make specific measurements and observations
  • Monitor and record intake and output. Report significant changes immediately
  • Observe, assess and record client’s physical and mental condition and reports any changes
  • Administer medications as instructed and as ordered by the physician and instructed by the RN
  • Work with patient, family and health care team members effectively to coordinate patient care
  • Maintain a high degree of confidentiality at all times due to access to sensitive information
  • Maintain regular, predictable, consistent attendance and is flexible to meet the needs of the agency
  • Follow all HIPAA regulations and requirements
What we offer
What we offer
  • Weekly Pay and Direct Deposit
  • Paid Time Off – Vacation and sick time accrual
  • A flexible schedule – Full Time and Part Time hours available
  • Exceptional support team. Manager is available 24 hours a day, 7 days a week
  • Programs offered: Referral bonus, rewards, employee discounts, and employee assistance
  • Excellent training program on day one… and ongoing
  • Career opportunities
  • Eligible employees and their dependents will be offered medical, hospitalization, vision, and dental benefits through the employer sponsored minimum essential plan
  • Employees are also eligible to enroll in employer sponsored retirement plan after 6 months of service (21 years of age)
  • Accrued paid time off (up to 80 hours per year based on tenure), and 1.5x pay for scheduled/worked covered holidays
Read More
Arrow Right

Occupational Health Registered Nurse

Do you have a passion for promoting, maintaining, and restoring the Occupational...
Location
Location
United States of America , Mehoopany
Salary
Salary:
85000.00 - 122200.00 USD / Year
us.pg.com Logo
Procter & Gamble
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • RN Nursing Degree or higher
  • An unencumbered nursing license and ability to obtain a license if not currently licensed in the state
Job Responsibility
Job Responsibility
  • Coordinate the care of ill and injured workers, including return to work assessment and fit for duty evaluation from medical leaves of absence, disability, worker’s compensation
  • Engage with site and regional medical resources to support clinical activities which includes following medical triage protocols, conduct virtual screenings, follow confinement guidelines, and plan appropriate RTW per standard operating procedures
  • Partner with Human Resources (HR) on Family Medical Leave Act (FMLA), American Disabilities Act (ADA) Interactive Process for site employees, and Incident Related Drug Testing
  • Partner with site emergency response teams to deliver quality and timely basic and advanced life support
  • Partner with HR and Health Safety and Environmental (HSE) and ensure occupational health aspects of local legal requirements
  • Ensure compliance with health aspects and medical testing requirements of TSCA, SARA, OSHA, NIOSH, P&G Medical and Industrial Health & Safety standards
  • Conduct new hire post-offer health questionnaire review, physicals, and medical qualification
  • Deliver comprehensive occupational health medical monitoring and medical qualification program for P&G employees
  • Develop, interpret, and administer medical testing programs such as Hearing Tests, and Respirator Physicals which include Pulmonary Function Tests, Phlebotomy as indicated and if needed
  • Work with third party vendors to facilitate health services programs and resources based on business needs
  • Fulltime
Read More
Arrow Right

RN - Pediatric Home Health

The Registered Nurse (RN) is responsible for utilizing the nursing process to pr...
Location
Location
United States , Fargo
Salary
Salary:
32.00 - 48.00 USD / Hour
intelycare.com Logo
IntelyCare
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Graduate from a nationally accredited nursing program preferred
  • Minimum of one year of professional nursing experience preferred
  • Currently holds an unencumbered RN license with the State Board of Nursing where the practice of nursing is occurring and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state
  • Obtains and subsequently maintains required department specific competencies and certifications
  • Depending on location, a valid drivers license may be required
  • Basic Life Support (BLS) required
Job Responsibility
Job Responsibility
  • Utilizing the nursing process (assessment, diagnosis, outcomes/planning, implementation and evaluation) to provide professional nursing services to patients/residents at home
  • Administering physician-ordered treatments and medications
  • Providing respiratory support, including ventilator care and suctioning
  • G-tube feeding and care
  • Assisting with personal care and daily living activities
  • Supporting individualized therapy and exercise programs
  • Taking clients to school
  • Collaborates with patient/resident and family, other inter-professional colleagues, such as physicians, to plan, implement and evaluate care
  • Cares for patients/residents in all phases of preventative care, health maintenance, diagnosis, treatment, and follow-up for patients/residents in the home setting
  • Responsible to implement the nursing process, the coordination and continuum of care, patient/resident assessment, patient/resident education, triage, and various other nursing interventions
What we offer
What we offer
  • Sign on BONUS for eligible applicants
  • Health insurance
  • Dental insurance
  • Vision insurance
  • Life insurance
  • A 401(k) retirement plan
  • Work/life balance benefits
  • A generous time off package
  • Fulltime
Read More
Arrow Right
New

Pharmacy Technician

We’re building a world of health around every individual — shaping a more connec...
Location
Location
United States , Drexel Hill
Salary
Salary:
Not provided
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
June 22, 2026
Flip Icon
Requirements
Requirements
  • Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
  • If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
  • If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
  • State-level licensure and national certification requirements vary by state, click here to learn more
  • Regular and predictable attendance, including nights and weekends
  • Ability to complete required training within designated timeframe
  • Attention and Focus
  • Customer Service and Team Orientation
  • Communication Skills
  • Mathematical Reasoning
Job Responsibility
Job Responsibility
  • Living our purpose by following all company SOPs at each workstation to help our Pharmacists manage and improve patient health
  • Following pharmacy workflow procedures at each pharmacy workstation (i.e., production, pick-up, drive-thru, and drop-off) for safe and accurate prescription fulfillment
  • Contributing to positive patient experiences by showing empathy and genuine care
  • Completing basic inventory activities, as permitted by law, and as directed by the pharmacy leadership team
  • Contributing to a high-performing team, embracing a growth mindset, and being receptive to feedback
  • Remaining flexible for both scheduling and business needs, while contributing to a safe, inclusive, and engaging team dynamic
  • Understanding and complying with all relevant federal, state, and local laws, regulations, professional standards, and ethical principles
  • Delivering additional patient health care services (e.g., immunizations, point-of-care testing, and voluntarily staffing offsite clinics), where allowable by law and supported by required training and certification
  • Where permissible, the Pharmacy Technician may also support immunizations, which includes the following responsibilities: Completing additional licensure and training requirements, in compliance with state Board of Pharmacy regulations, to obtain Technician Immunizer status to support preparing and administering vaccines
  • Educating patients about the importance of vaccines and referring patients to the Pharmacist-on-duty for vaccination questions
What we offer
What we offer
  • medical, dental, and vision coverage
  • paid time off
  • retirement savings options
  • wellness programs
  • and other resources, based on eligibility
  • Fulltime
Read More
Arrow Right
New

Mri Technologist

MedPro Healthcare Staffing, a Joint Commission-certified staffing agency, is see...
Location
Location
United States , Springfield
Salary
Salary:
Not provided
medprostaffing.com Logo
MedPro Healthcare Staffing
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Completion of a two year approved School of Radiologic Technology
  • Valid state radiology registration as required by state law
  • Registry by the American Registry of Radiologic Technology.
Job Responsibility
Job Responsibility
  • MRI technologists utilize their knowledge of anatomy, physiology and the principles of MRI to safely and efficiently operate MRI scanners, assisting in the diagnosis of disease and injury.
  • Ensure the safety of patients, staff and visitors who come in contact with the powerful magnetic field of a MRI scanner.
  • Position patients and coils on a table that slides inside the MRI scanner.
  • Inject contrast media as required.
  • Set appropriate technical parameters, operate MRI scanners and related equipment, and observe image data on computer monitors during scans.
  • Be familiar with the differences from a normal image and an abnormal image.
  • Recognize and respond to life threatening situations.
  • Assure compliance with federal, state, and local technical and professional regulations and accepted practiced guidelines.
  • Delivers quality, cost effective patient care in a professional manner.
  • Works effectively to maintain an environment of excellence, which is patient focused, providing timely, compassionate, quality patient care.
What we offer
What we offer
  • Weekly pay and direct deposit
  • Full coverage of all credentialing fees
  • Private housing or housing allowance
  • Group Health insurance for you and your family
  • Company-paid life and disability insurance
  • Travel reimbursement
  • 401(k) matching
  • Unlimited Referral Bonuses up to $1,000
  • Fulltime
Read More
Arrow Right