- Cognizant (Albany, NY)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... 7pm EST approximately 3-4 Thursday and Friday's annually. The Utilization Management Nurse 2 uses clinical...Qualifications** + Minimum of an Associate's degree + Licensed Registered Nurse (RN) with no disciplinary action… more
- CDPHP (Latham, NY)
- …two (2) years of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + ... of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review...recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York… more
- CVS Health (Albany, NY)
- …The schedule is Monday - Friday, 8:30am - 5pm EST. This role is a registered nurse that utilizes MCG rules and applies medical necessity guidelines to service ... within specific allowable turn around times. **Required Qualifications** + Registered Nurse with active and unrestricted New...unrestricted New York state licensure + 1+ year of Utilization review experience + 1+ year of clinical… more
- CVS Health (Albany, NY)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… more
- Bassett Healthcare (Cobleskill, NY)
- …needs. The RN contributes to the support of patients through interdisciplinary teamwork. + Registered Nurse I: The RN I status is only appropriate for a ... + Salary Range: $39.01 - $58.51 per hour + Registered Nurse II: The RN II status...and managerial observation + Demonstrates consideration of safety, effective utilization of equipment and materials, and cost in managing… more
- Bassett Healthcare (Cobleskill, NY)
- …are/remain exempt from this requirement. Experience: + Minimum one year experience as a Registered Nurse , if experience is not relevant, Registered Nurse ... RN residency program, required License/ Certification: + Current NYS license as a Registered Nurse , required + BLS certification will be required within 6… more
- CVS Health (Albany, NY)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …Former EDRP participants ineligible to apply. Responsibilities The Inpatient Staff Registered Nurse (RN) is responsible for providing competent, evidence-based ... orientation, competencies and providing quality improvement and enhance outcomes utilization . This nurse integrates knowledge, skills, abilities,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Trinity Health (Schenectady, NY)
- …to geriatrics recover from a stroke, traumatic injury or disabling illness. **Full Time Registered Nurse (RN) - Manager - Sunnyview Rehab Hospital - Brain ... friends, and families. + Serves as a resource, planner, clinical expert, manager and interdisciplinary coordinator. + Areas of...**What you will need:** + Current New York State Registered Professional Nurse licensure (The Program … more
- Bassett Healthcare (Cobleskill, NY)
- …Experience: + New graduate or less than one year of experience as a Registered Nurse , required License/ Certification: + NYS licensure as Registered ... best quality of life possible. What you'll do The Registered Professional Nurse I, Acute Care is...and managerial observation. + Demonstrates consideration of safety, effective utilization of equipment and materials, and cost in managing… more
- Whitney Young Health Center (Albany, NY)
- Registered Nurse (RN) Care Manager (Req 100984) Albany, NY (http://maps.google.com/maps?q=920+Lark+Drive+Albany+NY+USA+12207) Apply Description Be a part of the ... to identify patient for care coordination services. + Collaborate with providers/ clinical team members to identify target patient population for care coordination.… more
- Molina Healthcare (Albany, NY)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support...hearings as may be required. * Serves as a clinical resource for utilization management, chief medical… more
- Trinity Health (Troy, NY)
- …and perceiving our world and that these differences often lead to innovative solutions. ** Registered Nurse Professional Utilization Management Nurse - ... shifts to accommodate all schedules **What you will do:** + Perform utilization management, both concurrent and retroactive for inpatient and outpatient services in… more
- Humana (Albany, NY)
- …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... Facilities to obtain sufficient clinical information. The Utilization Management Behavioral Health Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- New York State Civil Service (Albany, NY)
- …in nursing AND current New York State license and registration as a professional registered nurse AND four years of post-licensure nursing experience. One year ... in nursing AND current New York State license and registration as a professional registered nurse AND three years of post-licensure nursing experience. One year… more
- New York State Civil Service (Albany, NY)
- …in nursing AND current New York State license and registration as a professional registered nurse AND four years of post-licensure nursing experience. One year ... the Associate Medical Director, the PHPN will serve as clinical subject matter expert and be responsible for overseeing...New York State license and registration as a professional registered nurse AND three years of post-licensure… more
- Albany Medical Center (Albany, NY)
- …computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire - ... works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to achieve… more
- Ellis Medicine (Schenectady, NY)
- …standards and regulatory requirements. Requirements: Currently licensed in New York State as a Registered Nurse and a graduate of an approved school of nursing. ... in performance improvement/research activities; maintains professional practice standards and clinical expertise; and demonstrates leadership skills. The Nurse … more