- Cognizant (Albany, NY)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Trinity Health (Albany, NY)
- …in Albany, NY** is looking for an experienced RN to work as a Registered Professional Utilization Management Nurse (UMRN) per diem. The team is willing to ... **The selected candidate will** : + Be responsible for the utilization management , both concurrent and retroactive for inpatient and outpatient services in… more
- Sharecare (Albany, NY)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Health, Department of Title Public Health Program Nurse (NY HELPS) - 07370 Occupational Category Health Care, Human/Social Services Salary Grade ... and Intervention (EHDI) Program. The candidate will provide program management and clinical oversight of public health program planning,...or contingent permanent status as a Public Health Program Nurse , G-24 OR NYS employee with one year or… more
- Ellis Medicine (Niskayuna, NY)
- Basic Function: The Nurse Manager (NM) actualizes the vision, mission and values for Ellis Medicine and maintains standards of the practice for nursing as defined by ... Standards of Practice and Nursing's social Policy Statement. The Nurse Manager participates in performance improvement/research activities; maintains professional… more
- Bassett Healthcare (Cobleskill, NY)
- …Schoharie County and the surrounding region What you'll do The Registered Professional Nurse (RN), Acute Care in the Medical Inpatient Unit is accountable for the ... needs. The RN contributes to the support of patients through interdisciplinary teamwork. + Registered Nurse I: The RN I status is only appropriate for a new nurse… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …education, orientation, competencies and providing quality improvement and enhance outcomes utilization . This nurse integrates knowledge, skills, abilities, and ... EDRP participants ineligible to apply. Responsibilities The Inpatient Staff Registered Nurse (RN) is responsible for providing competent, evidence-based care to… more
- Molina Healthcare (Albany, NY)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for… more
- Trinity Health (Schenectady, NY)
- …preferred or obtained within 2 years of hire. + Previous experience in nurse management required Our compassionate staff is there with up-to-the-minute treatment ... stroke, traumatic injury or disabling illness. **Full Time Registered Nurse (RN) - Manager - Sunnyview Rehab Hospital -...30 out of 1100+ rehab hospitals has a wonderful management opportunity! We at St. Peter's Health Partners recognize… more
- Bassett Healthcare (Cobleskill, NY)
- …Schoharie County and the surrounding region" What you'll do The Registered Professional Nurse II, Acute Care is accountable for the delivery of safe patient care ... feedback and managerial observation. + Demonstrates consideration of safety, effective utilization of equipment and materials, and cost in managing patient care,… more
- Molina Healthcare (Albany, NY)
- …of payment decisions. * Serves as a clinical resource for utilization management , chief medical officers, physicians and member/provider inquiries/appeals. ... JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring timely claims payment… more
- Bassett Healthcare (Cobleskill, NY)
- …Schoharie County and the surrounding region" What you'll do The Registered Professional Nurse I, Acute Care is accountable for the delivery of safe patient care ... and job description is only appropriate for a new nurse in the first year of practice, as support...and managerial observation. + Demonstrates consideration of safety, effective utilization of equipment and materials, and cost in managing… more
- Evolent (Albany, NY)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Nurse Manager - Outpatient Cardiology Office - Albany, NY - FT - Days** If you are looking for ... a Clinical Nurse Manager position in an Outpatient Cardiology practice, this...as appropriate governmental and other regulatory standards. Insures clinical management presence during working hours. + Ensures timely performance… more
- Highmark Health (Albany, NY)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Evolent (Albany, NY)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… 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 ... professional nursing practice, excellent communication and critical thinking skills, self- management expertise along with outstanding customer service to promote and… more
- Trinity Health (Albany, NY)
- … Management :** + Direct daily operations, ensuring efficient resource utilization , staffing, and workflow optimization. + Oversee budgeting, resource allocation, ... **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Nurse Director for Cardiovascular Service Line Surgical at...and financial management to achieve cost-effectiveness and profitability. + Ensure compliance… more
- Molina Healthcare (Albany, NY)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review. + Minimum two years of experience in… more
- Molina Healthcare (Albany, NY)
- …Preferred License, Certification, Association Active, unrestricted Utilization Management Certification (CPHM). LVN (Licensed Vocational Nurse ) or ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more