- 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
- CVS Health (Albany, NY)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- Albany Medical Center (Albany, NY)
- …by assuring communication with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State current license.* Bachelor's ... stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and… 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)
- …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
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …Former EDRP participants ineligible to apply. Responsibilities The Critical Care Registered Nurse is responsible for providing competent, evidence-based care ... equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion… 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
- 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
- CVS Health (Albany, NY)
- …a member's overall wellness through integration. - Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and ... functions as well as smooth transition to programs and plans. - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and… 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
- CDPHP (Latham, NY)
- … clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... of consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and… more
- University of Rochester (Albany, NY)
- …of orientation at the unit level required **LICENSES AND CERTIFICATIONS** + RN - Registered Nurse - State Licensure and/or Compact State Licensure upon hire ... standards development, human resource management, assessment of resource needs and utilization , staff development and communication within nursing practice as well… more
- Ellis Medicine (Niskayuna, NY)
- …EDUCATION AND EXPERIENCE REQUIREMENTS: + Currently licensed in New York State as a Registered Nurse and a graduate of an approved school of nursing. + ... Join our team and GROW with Ellis! The Administrative Clinical Supervisor functions as the administrative manager during the... Supervisor will work collaboratively with the DON and Nurse Managers to assure effective and efficient utilization… more
- CVS Health (Albany, NY)
- …Operations and others on initiatives for Stars/quality improvement **Required Qualifications** - Registered Nurse with active and unrestricted license in state ... Stars and quality but will also focus on improvements in utilization and cost. The Senior Clinical Strategist works to drive clinical performance of assigned… more