- 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 ... SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action… 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) Compact license, with no… 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
- Humana (Albany, NY)
- …make an impact** **Required Qualifications** + Associate's Degree or higher + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary ... health first** This is an opportunity to use your clinical knowledge and research skills to support the coordination,...an 8.5-hour shift between 7:00am - 5:00pm CST. The Utilization Management Nurse 2 uses knowledge, communication,… 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
- 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
- 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
- CenterWell (Albany, NY)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… 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
- Whitney Young Health Center (Albany, NY)
- …other duties as assigned. Requirements MINIMUM QUALIFICATIONS: + Graduate of a registered approved Nurse Practitioner/Physician Assistant Program + Completion of ... required State/National Certification Programs + Current licensure and registration as a Registered Professional Nurse /Physician Assistant in the State of New… more
- Molina Healthcare (Albany, NY)
- …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse (RN). License must be active and unrestricted in ... for denial or modification of payment decisions. + Serves as a clinical resource for utilization management, CMOs, physicians and member/provider… more
- Sharecare (Albany, NY)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more