- CVS Health (Albany, NY)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... required in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST time zone.… more
- CVS Health (Albany, NY)
- …do it all with heart, each and every day. **Position Summary** This ** Utilization Manager** position is with Aetna's Long-Term Services and Supports (LTSS) team and ... is for candidates to hold a **New York Registered Nurse ** License. This employee will work four - 10...unrestricted New York state licensure + 1+ year of Utilization review experience + 1+ year of clinical experience… more
- CVS Health (Albany, NY)
- …And we do it all with heart, each and every day. Requisition Job Description Utilization Management is a 24/7 operation and work schedule may include weekends ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
- Lincoln Financial (Albany, NY)
- …Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible ... for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state...Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's… more
- Highmark Health (Albany, NY)
- … **SKILLS** + Deep Clincal Expertise -extensive knowledge of clinical, quality, care, utilization , high-cost claim, and population health management . Must be a ... in Business or Clinical field **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse (RN) or Pharmacist (Pharm D) or Physician Assistant (PA) **Preferred** +… more
- Albany Medical Center (Albany, NY)
- …works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to ... appropriate LOS and financial constraints. + Provides collaborative care management with the primary nurse in assessing...assigned service - required + Recent experience in case management , utilization management and/or discharge… more
- Albany Medical Center (Albany, NY)
- …proactively with the Quality Improvement Teams, patient care standards, Social Work, and utilization management to coordinate the appropriate use of resources to ... outcomes within appropriate LOS and financial constraints. c. Provides collaborative care management with the primary nurse in assessing for discharge planning… more
- Ellis Medicine (Schenectady, NY)
- …psychosocial needs and coordinate transition of care with Social Worker + Serves as nurse consultant for Social Worker cases with Clinical or discharge planning ... Services discharge planning guidelines and departmental/organizational policies and processes + Utilization Management : + Ensures order in chart/EMR coincides… more
- Trinity Health (Albany, NY)
- …is to provide on-site support and assistance to hospital case management and hospitalist team to ensure timely identification of inpatients appropriate ... members, referral sources, and external payers regarding the effective and efficient utilization of program services and available resources. + Screening of clients… more