Clinician

• Assess patients and formulate, implement, and follow up on comprehensive prosthetic and orthotic treatment plans
• Collaborate with physicians and rehabilitation team members on patient evaluations and treatment options
• Design, fabricate, select materials for, fit, align, adjust, and evaluate prosthetic and orthotic devices
• Instruct patients in the use of prosthetic and orthotic devices and resolve device issues
• Provide follow-up with patients and physicians
• Deliver in-service training to physicians and allied health professionals
• Manage materials, quality, performance, costs, and medical efficacy
• Build relationships with physicians, case managers, and referral sources
• Plan and implement strategies to meet revenue targets
• Maintain detailed clinical notes and support reimbursement activities
• Mentor residents or newly certified clinicians and assist clinical staff
• Comply with safety, Medicare, governmental, bloodborne, and OSHA requirements
• Perform on-call, hospital calls, or float between Hanger Clinic locations as needed

Prosthetist/Orthotist providing rehabilitation care for Hanger Clinic patients in Omaha

Prosthetist and/or Orthotist Clinician, CPO, Board Eligible

Prosthetist/Orthotist delivering prosthetic and orthotic rehabilitation care for adult and pediatric patients at Hanger Clinic’s Omaha practice.
Collaborating with physicians and rehabilitation teams to design, fit, and optimize patient devices.

• Partner with clinical staff to develop and refine comprehensive treatment plans that address mental health, substance use, educational, and vocational needs
• Lead and participate in interdisciplinary case conferences to ensure aligned, high-quality care
• Deliver individual, group, and workshop-based therapeutic services in collaboration with the clinical team
• Provide ongoing clinical supervision, coaching, and staff development, fostering skill-building and accountability
• Oversee and coordinate patient case management, working closely with social services, legal entities, schools, and community providers
• Review and ensure quality of clinical documentation, supporting compliance and best practices
• Lead or support clinical case review processes and continuous program improvement efforts
• Guide clients and staff through treatment progression, ensuring appropriate transitions and continuity of care
• Support discharge planning and re-entry, ensuring clients are equipped with resources and referrals for long-term success

Licensed Clinician leading clinical quality at Brentwood Mental Health Clinic

Licensed Clinician

Licensed Clinician leading clinical quality at Brentwood Mental Health Clinic. Shaping treatment journeys and enhancing the growth of clinical staff in a nonprofit environment.

• Ensuring appropriate, consistent administration of plan benefits by reviewing clinical information and assessing medical necessity under relevant guidelines and/or medical policies
• Confirming medical services are appropriate based on assigned benefit plan, medical policies, clinical guidelines, plan benefits, and/or scripted algorithms
• Handling less complex benefit plans and/or contracts
• Conducting and may approve precertification, concurrent, retrospective, out-of-network, and/or appropriateness of treatment setting reviews by assessing clinical information against appropriate medical policies, clinical guidelines, and the relevant benefit plan/contract
• Referring complex or non-routine reviews to more senior nurses and/or Medical Directors

Medical Management Clinician Associate ensuring plan benefits administration and medical necessity assessment

Medical Management Clinician Associate

Medical Management Clinician Associate responsible for benefit plans administration and medical necessity assessments. Requires clinical experience and appropriate licensure for virtual healthcare role.

• Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and NCQA standards
• Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal
• Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards
• Communicates with members, providers, facilities, and other departments regarding appeals requests
• Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards
• Works with leadership to increase the consistency, efficiency, and appropriateness of responses of all appeals requests
• Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices
• Performs other duties as assigned
• Complies with all policies and standards

Clinical Review Clinician performing appeals reviews in behavioral health for Centene.

Clinical Review Clinician – Appeals, Behavioral Health

Clinical Review Clinician performing behavioral health appeals reviews for Centene's Medical Management team. Responsible for ensuring compliance with clinical data, policies, and NCQA standards.

• Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards
• Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal
• Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards
• Communicates with members, providers, facilities, and other departments regarding appeals requests
• Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards
• Works with leadership to increase consistency, efficiency, and appropriateness of responses of all appeals requests
• Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices
• Performs other duties as assigned
• Complies with all policies and standards

Clinical Review Clinician in Medical Management reviewing appeals for health services

Clinical Review Clinician – Appeals

Clinical Review Clinician managing medical necessity reviews in the appeals process for a national health services organization. Work includes collaborating with medical directors and ensuring compliance with healthcare standards.

• Provide behavioral health support to members in an in-person and virtual setting.
• Develop member care plans for members when behavioral health interventions are needed.
• Provide clinical education to members on preventative care topics, including behavioral health and mental illness.
• Make appropriate referrals for medical support, social resources, behavioral health and Substance Use Disorder (SUD) to external and internal providers or internal care team.
• Collaborate with internal care teams to assess and determine need for member escalation or placement in different programs (e.g., lower or higher intensity program).
• Maintain engagement with high-acuity members.

Behavioral Health Clinician providing support to members with serious mental illness

Behavioral Health Clinician, LCSW/LMHC

Behavioral Health Clinician providing support to members with serious mental illness at Cityblock Health, primarily in a virtual setting with some in-person interactions.

• 100% amount of time will be spent delivering clinical services.
• Working with Adolescents and Families in a school/clinical setting.
• Provide DSM diagnostic assessment and treatment plan and make appropriate recommendations and referrals and document in accordance with regulatory agencies and policy and procedures.
• Implement interventions utilizing Evidence Based Practices
• Participate in (IDT) interdisciplinary treatment team meetings focused on client mental health care.
• Facilitate groups using Evidence Based Practices to assist and empower clients in improving their ability to manage their mental health needs and achieve recovery.
• Consultation/supervision with attending psychiatrist and mental health specialist on best course of treatment recommendations and dispositions.

Clinician providing clinical services to adolescents and families in Bronx, NY

Clinician, LMSW, LCSW, LMHC, LMFT, LCAT

Clinician providing clinical services to adolescents and families in Bronx, NY. Delivering DSM assessments, developing treatment plans, and facilitating groups for mental health management.

• Conducts initial nursing assessments for home infusion therapy
• Trains patients/caregivers on procedures and equipment
• Develop and revises care plans with the healthcare team
• Visits patients, documents compliance, and provides direct care
• Assuming on-call duties and managing patient supplies
• Coordinates care with other agencies and counsels patients on therapy
• Collaborate with Pharmacists for therapy adjustments
• Plans efficient daily routes and submits nursing notes promptly
• Triages field problems and adheres to SOPs and regulations
• Delivers "white glove" service and submits travel expense reports
• Projects a positive attitude and participates in employee activities
• Provides nursing services as requested, including weekends and evenings
• Performs other duties as assigned

Registered Home Infusion Nurse providing specialized nursing care in patient homes

Nurse Clinician

Registered Home Infusion Nurse providing specialized nursing care in patient homes. Assessing, planning, implementing, and evaluating patient care plans with a focus on quality care.

Clinician jobs in New York

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