- 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
- 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
- CVS Health (Albany, NY)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… 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
- Dartmouth Health (Bennington, VT)
- …matriculated into a BSN program may be considered.Prior experience in utilization review, discharge planning and/or case management preferred.3-5years of recent ... clinical experience required. VT Nursing License required by date...experience and BS required. BSN preferred. Prior experience in utilization review, discharge planning and/or case management preferred. VT… 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
- Humana (Albany, NY)
- …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... of action. The Utilization Management Behavioral Health Nurse uses clinical knowledge, communication skills, and...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… 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
- 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
- CenterWell (Pittsfield, MA)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... on-site at our Pittsfield, MA branch location.** The **RN Clinical Manager** coordinates and oversees all direct care patient...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… 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)
- …performing the job functions. **Required Qualifications** - 5+ years' experience as a Registered Nurse with hospital experience; preferably in the specialty. - A ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that... Registered Nurse that holds an unrestricted license… more