- Independent Health (Buffalo, NY)
- …perks, benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Utilization Review Nurse (URN) performs clinical review ... clinical experience as an RN in a varied clinical setting required. + Previous utilization review experience preferred. + Previous experience in a managed care… more
- New York State Civil Service (Buffalo, NY)
- NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), Greater Binghamton Health Center, P26033 Occupational Category ... Street City Buffalo State NY Zip Code 13904 Duties Description As a Utilization Review Coordinator, your duties will include:* Reviewing clinical records for… more
- Catholic Health (Buffalo, NY)
- …with Weekend and Holiday Rotation Hours: 7:00pm to 7:00am Summary: The Nurse Residency position offers training, education and professional development through a six ... encompasses the Emergency Department (ED), Intensive Care Unit (ICU). The nurse resident systematically and continuously assists in the collection and assessment… more
- Catholic Health (Kenmore, NY)
- …with Weekend and Holiday Rotation Hours: 6:45pm to 7:00am Summary: The Nurse Residency position offers training, education and professional development through a six ... encompasses the Emergency Department (ED) and Intensive Care Unit (ICU). The nurse resident systematically and continuously assists in the collection and assessment… more
- Molina Healthcare (Buffalo, NY)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases… more
- Catholic Health (Buffalo, NY)
- …Two (2) years acute care RN experience required + Preferred prior insurance /managed care/ utilization review experience in the role of a Case Manager or Disease ... Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York State + New...Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York State + New… more
- Catholic Health (Kenmore, NY)
- …(2) years acute care and/or community health nursing + Preferred prior insurance /managed care/ utilization review experience in the role of a Case Manager or ... between Kenmore Mercy and Sister's Hospital Summary: The Registered Nurse (RN) Care Manager-Transition of Care, as an active...Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York State + New… more
- Molina Healthcare (Buffalo, NY)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be… more
- Independent Health (Buffalo, NY)
- …that fosters growth, innovation and collaboration. **Overview** The Behavioral Health Utilization Review Clinician will primarily be responsible for managing ... behavioral health benefits through utilization management functions as well as case management activities....a LCSW, LMSW, LMHC, LPC, LMFT) or a Registered Nurse (RN) with active, unrestricted NYS license required. +… more
- Molina Healthcare (Buffalo, NY)
- …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
- Kaleida Health (Buffalo, NY)
- …2 years of experience in any combination of case management, home care and utilization review preferred. Knowledge of and experience with Interqual Criteria set ... with members of the interdisciplinary team to coordinate care, facilitate utilization and resource management and discharge planning functions, working to achieve… 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 interdisciplinary complex ... management rounds. + Provision of clinical oversight and leadership to Utilization Management/Case Management (UM/CM) staff working with the children's population. +… more
- STG International (West Seneca, NY)
- …safety. + Participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... Participate in the orientation of clinical staff physicians, physician assistants and nurse practitioners. + Provide leadership to CBOC clinicians. + Evaluate the… more
- Veterans Affairs, Veterans Health Administration (Buffalo, NY)
- …Part II, Appendix G. The Advanced MSA coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization ... of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. ... consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory… more
- Amergis (Buffalo, NY)
- Salary: $2400 / Week Amergis Healthcare Staffing is seeking a Registered Nurse Clinical Admissions responsible for the coordination and planning for pre-admission ... Ability to work collaboratively with medical staff + Experience in Case Management, Utilization Management or Discharge Planning preferred + Must be at least 18… more