- Elevance Health (Latham, NY)
- ** Clinical Review Nurse I - Medicare Part A** **Location:** This role enables associates to work virtually full-time, with the exception of required ... for Medicare and Medicaid Services to transform federal health programs. The ** Clinical Review Nurse I** is responsible for reviewing and making medical… more
- Evolent (Albany, NY)
- …staff and Field Medical Directors. **What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not pass the ... for the culture. **What You'll Be Doing:** As a Clinical Reviewer, Nurse , you will be a...record documentation in order to approve services that meet clinical review criteria. + Conducts ongoing activities… more
- Sharecare (Albany, NY)
- …affordable for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals ... and cost-effective manner while ensuring high quality care. The Clinical Registered Nurse coordinates with the Primary...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- CDPHP (Albany, NY)
- …The Utilization Review (UR) Nurse is responsible for the clinical review and documentation for services requiring prior authorization. This includes ... with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
- Albany Medical Center (Albany, NY)
- …(United States of America) Salary Range: $76,396.32 - $126,730.61 A Pre-Admission Testing Nurse plays a crucial role in ensuring the safe and efficient preparation ... prepared for their procedures. Attention to detail, strong communication skills, and clinical expertise will contribute to the overall quality of care provided to… more
- Elevance Health (Latham, NY)
- …outpatient precertification, prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for ... I** will be responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing incoming calls or… more
- Albany Medical Center (Albany, NY)
- …and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and contacts ... assigned patients.* Discusses payor criteria and issues and a case-by-case basis with clinical staff and follows up to resolve problems with payors as needed.* Uses… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- Summary The Albany VAMC is looking to fill (1) Registered Nurse - ACCREDITATION QUALITY SPECIALIST position. You will be expected to travel for this position. You ... with driving requirements for this position. Responsibilities The Registered Nurse Accreditation Quality Specialist executes leadership that is characterized by… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities The Inpatient Staff Registered Nurse (RN) is responsible for providing competent, evidence-based care to patients with oversight of licensed… more
- Trinity Health (Latham, NY)
- … Manager - Orthopedics Office - Latham, NY** If you are looking for a Clinical Nurse Manager position in Orthopedic medicine, this could be your opportunity. ... tuition allowance and career development **What you will do:** The Manager of Clinical Care is directly responsible for the daily supervision of the clinical… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Nurse - RNII -Cardiology Office - Phone Triage - Albany, NY - Full Time** If you are looking ... patients call with cardiac symptoms. Patient education via phone or nurse visits. Prescription refills, prior authorization for medicine. **Position Highlights:** +… more
- CVS Health (Albany, NY)
- …clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory ... needs to ensure appropriate administration of benefits. + Applies clinical judgment to the incorporation of strategies designed to...**Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in… more
- CVS Health (Albany, NY)
- …clients - Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory ... needs to ensure appropriate administration of benefits - Applies clinical judgment to the incorporation of strategies designed to...**Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year of experience in… more
- Intermountain Health (Albany, NY)
- **Job Description:** The Nurse Care Manager works collaboratively with physicians and other members of the health care team to improve the health of patients with ... addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management. **Job Specifics** + Pay Range: $40.39… more
- YesCare Corp (Coxsackie, NY)
- …Veterans._ **Responsibilities** Below is a list of your responsibilities as a ** Nurse Practitioner (NP/ARNP)** withYesCare: + **For this New York United States-based ... community standard care based on evidenced based medicine for clinical services required including but not limited to sick...in-service education of staff as requested. Participates in monthly review of quality of care and chart reviews as… more
- CenterWell (Albany, NY)
- …regarding Home Health, Hospice, and Palliative Care Services. + Assist with clinical eligibility review for alternate services + Participates in special ... **When working weekends, it will allow for off-days during the week.** The ** Clinical Care Coordinator** helps to ensure optimal continuity of care for patients… more
- Trinity Health (Troy, NY)
- …supervision and 80% of the time in administrative duties. The Patient Care Services Nurse Manager of the Burdett Birth Center will report to the SPHP Maternity ... Services System Director. The Nurse Manager responsibilities include maintaining a high patient satisfaction, ensuring that clinical operations are effective,… more
- Intermountain Health (Albany, NY)
- **Job Description:** Remote Full Time 40 hrs/wk. position. The nurse care manager works collaboratively with physicians and other members of the health care team to ... addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management. **Position Details:** + Remote (with face… more
- Albany Medical Center (Albany, NY)
- …States of America) Salary Range: $86,650.99 - $134,309.04 The Wound Ostomy Continence (WOC) Nurse is an expert in the nursing care of those with wound, ostomy, and ... institution and throughout the acute care stay. The WOC Nurse functions as a care provider directly through hands-on... functions as a care provider directly through hands-on clinical support and indirectly as educators, consultants and … more
- CVS Health (Albany, NY)
- …leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members, who are ... warm transfers form concierge and engagement hub - Provides clinical assistance to determine appropriate services and supports due...who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current… more