- Albany Medical Center (Albany, NY)
- Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Utilization Review Nurse Salary Range: $31.28 - $51.61 per hour ... for assigned patients. Qualifications and Ideal Characteristics + Registered nurse with a New York State current license. +...Basic knowledge of computer systems with skills applicable to utilization review process. + Excellent written and… more
- CDPHP (Albany, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... for acute and subacute rehabilitation, transportation and DME requests. Review of identified high-cost admissions and extended stays and...acute care experience is required as a Licensed Practical Nurse . + Minimum of two (2) years Utilization… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... Work Work Shift: Day (United States of America) Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. Salary… more
- Humana (Albany, NY)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Elevance Health (Latham, NY)
- …medical decisions to members and providers. **Job Summary:** + Perform physician-level case review , following initial nurse review , of Medical Oncology ... regimens and supportive care. + Perform physician-level case review , following initial nurse review ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- CDPHP (Albany, NY)
- …one (1) year clinical experience required. + A minimum of two (2) years quality/ utilization review experience in an HMO, managed care organization, or similar ... invites you to be a part of that experience. The Clinical Review and Coding Nurse is responsible to attain procedure and diagnosis coding accuracy and… more
- Albany Medical Center (Albany, NY)
- …Demonstrates experience in the referral process and use of community resources. 2. Utilization Review a. Reviews data from admission screening to clarify ... changing environment. 8. Basic knowledge of computer systems with skills applicable to utilization review process. Mission, Core Values and Service Excellence 1.… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities The duties of the RN include, ... but are not limited to: Demonstrates ability to function effectively in charge nurse , team leader, or other leadership roles. Applies problem-solving skills at the… more
- Elevance Health (Albany, NY)
- ** Nurse Reviewer I** **Location:** Within 50 miles of a pulse point **Shift** : Monday - Friday, from 9:30 am - 6 pm The ** Nurse Reviewer I** is responsible for ... on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with… more
- Albany Medical Center (Albany, NY)
- …Shift: Day (United States of America) Salary range: $68,640 - $99,023 Registered Nurse General Pediatrics Office Work schedule: Monday - Friday 8:00am - 4:30pm (with ... advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN),...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
- Fresenius Medical Center (Troy, NY)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Marriott (Albany, NY)
- …workers' compensation losses. The NCM is responsible for conducting first level Utilization Review and coordinates subsequent levels if necessary, as required ... **Additional Information** Nurse CARE Manager (CARE - Coordinated Action and...that may include multiple states. + Conducts first level utilization review per jurisdictional requirements. + Coordinates… more
- Albany Medical Center (Albany, NY)
- …scheduling patients for both in person and telehealth visits * Participate in nurse visits including medication review , education and follow-up; patient and ... parent education * Facilitates the utilization of resources to meet patient outcomes and contribute...for both in person and telehealth visits* Participate in nurse visits including medication review , education and… more
- Ellis Medicine (Schenectady, NY)
- …for the comprehensive integration of Discharge Planning, Performance Improvement and Utilization Review activities at patient, hospital, and system levels. ... as a RN in New York State. Experience: Previous Utilization Review , Quality Assessment, Discharge Planning or...the systems in which we work. * Serves as nurse consultant for Social Worker cases with Clinical or… more
- CenterWell (Clifton Park, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...State requirements. + Current state license as a Registered Nurse . + 2 years of Home Health experience with… more
- Albany Medical Center (Albany, NY)
- …Per Diem (United States of America) Salary range: $33/hr. - $47.60/hr. Registered Nurse (RN) General Pediatrics Office - Albany, NY Per Diem, minimum 24hrs required ... advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN),...* Performs venipuncture per order of MD/APP * Performs review and triage of incoming test results, patient requests… more
- Albany Medical Center (Albany, NY)
- …own team, manages, and maintains staff assignments, hires and performs employee review , trains, and coaches' staff as needed, develops and reports department ... In conjunction with clinical perioperative leadership, identify standardization and utilization opportunities. + Define business requirements for supplies, implants,… more
- Albany Medical Center (Albany, NY)
- …Responds to changes in work efficiently and effectively. + Support implementation and utilization of clinical nursing research. + Promote the use by colleges and ... and procedures, while engaging in and advocating for succession planning for nurse leaders. + Establishes standards for all department personnel by having… more
- Trinity Health (Albany, NY)
- …Skilled Nursing Facilities have a unique opportunity for a RN to receive, review and process referrals of patients at St. Peter's Hospital referred for subacute ... members, referral sources, and external payers regarding the effective and efficient utilization of program services and available resources. + Screening of clients… more
- Albany Medical Center (Albany, NY)
- …Work Shift: Day (United States of America) Salary range: $68,640 - $99,023 Registered Nurse (RN) - Full Time Pulmonary & Critical Care Office - Albany, NY Work ... advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN),...+ Performs venipuncture per order of MD/APP + Performs review and triage of incoming test results, patient requests… more