- Elevance Health (Buffalo, NY)
- RN Utilization Management - Case Management (Medicaid Long Term Care) JR155671 **Location** : New York or New Jersey. **Virtual:** This role enables ... face-to-face onboarding and skill development as needed. The **Medical Management Nurse ** is responsible for review of...and Experiences:** + A combination of utilization review/ utilization management and Case … more
- Trinity Health (Albany, NY)
- …+ 2 years of experience in acute setting **Preferred requirements:** + 1+ year of experience in case management or utilization management + Case ... **Employment Type:** Full time **Shift:** Evening Shift **Description:** ** RN Case Manager** **Full-Time Eves -...Engage the patient and care team in the joint management of key patient outcomes such as management… more
- Healthfirst (NY)
- … including preauthorization of outpatient or inpatient services + Knowledge of utilization management /quality management case philosophies and ... **Duties/Responsibilities:** + Oversees utilization management functions which include timely...**Minimum Qualifications:** + Associates degree + New York State Registered Nurse + Work experience demonstrating verbal… more
- MVP Health Care (Schenectady, NY)
- …New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months after hire. + At least 3 years of ... interaction **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes… more
- Mohawk Valley Health System (Utica, NY)
- RN Case Manager - Case Management - per diem Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision of Case ... regulatory compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review/ case management experience or social work… more
- Mount Sinai Health System (New York, NY)
- …assure timely and efficient care to patients, the delivery of comprehensive front-line Case Management services, including utilization management , care ... degree preferred + 5 years of Case Management and 6 years as a clinical nurse...New York State + Certification in case management is preferred Non-Bargaining Unit, BEZ - Utilization… more
- Ellis Medicine (Schenectady, NY)
- …I BASIC FUNCTION: The RN Case Manager has responsibility for case management of assigned patients on a designated unit(s). This position works with ... Case Manager include, but are not limited to, utilization review, case management , care...Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending… more
- Independent Health (Buffalo, NY)
- …primarily be responsible for managing behavioral health benefits through utilization management functions as well as case management activities. ... as a LCSW, LMSW, LMHC, LPC, LMFT) or a Registered Nurse ( RN ) with active,...required. + Experience in a health plan/managed care setting, utilization management , case management… more
- Albany Medical Center (Albany, NY)
- …of three years clinical experience in an assigned service.* Recent experience in case management , utilization management and/or discharge planning/home ... of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay ...with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State… more
- Trinity Health (Troy, NY)
- …through Friday - Samaritan HospitalIf you are looking for a position in RN ( Registered Nurse ) Case Management in a dynamic hospital, this could ... member of our caring, compassionate health care team the RN Case Manager will enjoy: Tuition assistance...experience in acute settingPreferred requirements:1+ year of experience in case management or utilization managementCase… more
- Mohawk Valley Health System (Utica, NY)
- Transitional Care RN - Case Management - Full Time - Days Department: CASE MANAGEMENT Job Summary The RN - Transitional Care Coordinator is ... experience. + 3 years of clinical experience. + Strong computer skills. PREFERRED: + Case Management , Utilization Management and Quality Management… more
- Glens Falls Hospital (Glens Falls, NY)
- …week, can be found*here*. **Job:** **Nursing - Case Management * **Title:** * Registered Nurse ( RN ) - Care Manager (GFMG) (Flexible Scheduling Options ... work closely with the Interdisciplinary Team to ensure appropriate utilization and provision of resources for patients including referrals...CCM or two years acute care/home * Care and/or case management experience preferred. * Masters Degree… more
- Crouse Hospital (Syracuse, NY)
- …management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... agreements. Manager, Care Coordination Requirements: + Licensed as a Registered Nurse in New York State +...State + Bachelor's degree + Five (5) years previous case management / discharge planning in an acute… more
- CVS Health (Albany, NY)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- CVS Health (Albany, NY)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year...keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Albany Medical Center (Albany, NY)
- …in an assigned service. Acute care nursing experience preferred.4. Recent experience in case management , utilization management and/or discharge ... proactively with the Quality Improvement Teams, patient care standards, Social Work, and utilization management to coordinate the appropriate use of resources to… more
- Northwell Health (Huntington, NY)
- **Req Number** 161299 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality ... + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria +… more
- Trinity Health (Syracuse, NY)
- …affiliated nursing program. BSN graduate preferred. + **Licensure** : Current Licensure as a Registered Nurse RN in New York. + **Certification** : BLS/CPR. ... 3 years Acute Care Setting, 1 year of Community Health preferred. Knowledge of Case Management / Utilization Management processes **Work Schedule** : Full… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …timely manner and provides support for the Case Management (CM) and Registered Nurse ( RN ) reviewers and manages the denial process. + Leads ... management rounds. + Provision of clinical oversight and leadership to Utilization Management / Case Management (UM/CM) staff working with the… more
- Crouse Hospital (Syracuse, NY)
- …establish the plan of care. Care Manager Position Requirements: + Must have a current Registered Nurse ( RN ) license. + Graduate from an accredited nursing ... (3) - Five (5) years acute hospital experience. + Case Management or Utilization ...YMCA Subsidy program. + Clinical Nursing Pathway Program for Registered Nurses designed to foster career growth and progression.… more