- MVP Health Care (Schenectady, NY)
- …New York Qualifications you'll bring: Current New York State Licensure as a Registered Nurse required. Certification in Case Management required within 24 months ... after hire. At least 3 years of recent clinical and Case Management experience. Experience working in a...to maintain cost-effectiveness and manage Medical Loss Ratio (MLR). Appeals & Denials: Participate in the appeals … more
- Cognizant (Albany, NY)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and… 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 ... resource for utilization management, chief medical officers, physicians and member/provider inquiries/ appeals . * Provides training and support to clinical peers.… more
- Molina Healthcare (Albany, NY)
- …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. **Job Summary** Utilizing clinical knowledge… more
- MVP Health Care (Schenectady, NY)
- …York** **Qualifications you'll bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 ... after hire. + At least 3 years of recent clinical and Case Management experience. Experience working in a...maintain cost-effectiveness and manage Medical Loss Ratio (MLR). + Appeals & Denials: Participate in the appeals … more
