- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... environment.* Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal communication skills.*… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... Work Work Shift: Day (United States of America) Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. Salary… more
- Sedgwick (Albany, NY)
- …and consult review ; and two (2) years of experience in daily application of nurse auditing, utilization review and bill review . **Skills & ... Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Bill Review **PRIMARY PURPOSE** **:** To review hospital...RN Bill Review **PRIMARY PURPOSE** **:** To review hospital and professional medical bills from providers including… more
- Albany Medical Center (Albany, NY)
- …a changing environment. + Basic knowledge of computer systems with skills applicable to utilization review process. Thank you for your interest in Albany Medical ... works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to achieve… more
- Elevance Health (Latham, NY)
- Nurse Audit Lead - Carelon Payment Integrity **Location:** The ideal candidate will live within 50 miles of one of our pulse point locations and will work on a ... is determined to recover, eliminate, and prevent unnecessary medical-expense spending. The ** Nurse Audit Lead** is responsible for leading a team of clinicians… more
- St. Mary's Healthcare (Amsterdam, NY)
- …denials by drafting appeals, negotiating with payers, or following up with payer utilization review departments in attempts of obtaining authorizations and claim ... with medical staff and care coordination leaders to ensure ongoing compliance with utilization review guidelines. * Collaborates with managed care department to… more
- Elevance Health (Latham, NY)
- **Telephonic Nurse Case Manager Senior** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager Senior** is responsible for care management within the scope of… more
- Trinity Health (Troy, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Nurse Manager - Vascular Surgery Offices - Capital Region - FT** If you are looking for a ... program, generous tuition allowance and career development **What you will do:** The Nurse Manager of Clinical Care is directly responsible for the daily supervision… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and ... in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly...transition of care with Social Worker + Serves as nurse consultant for Social Worker cases with Clinical or… more
- Ellis Medicine (Schenectady, NY)
- …for the comprehensive integration of Discharge Planning, Performance Improvement and Utilization Review activities at patient, hospital, and system levels. ... as a RN in New York State. Experience: Previous Utilization Review , Quality Assessment, Discharge Planning or...the systems in which we work. * Serves as nurse consultant for Social Worker cases with Clinical or… more
- CenterWell (Clifton Park, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...State requirements. + Current state license as a Registered Nurse . + 2 years of Home Health experience with… more
- GE Vernova (Schenectady, NY)
- …the Global M&E leader is required to ensure HC/LC targets are met and utilization of resources is maximized. The HRSG Team Leader will have the global responsibility ... The HRSG Team Leader M&E Field Resources is involved in the site operation review , identify the competencies required for the site execution. . Timely nomination of… more
- Albany Medical Center (Albany, NY)
- …Work Shift: Day (United States of America) Salary range: $68,640 - $99,023 Registered Nurse (RN) - Full Time Ear, Nose, and Throat Surgery Office Work schedule: ... practice at Albany Med is seeking a dynamic Registered Nurse to join our team! This is a fast-paced...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
- Albany Medical Center (Albany, NY)
- …Per Diem (United States of America) Salary range: $33/hr. - $47.60/hr. Registered Nurse (RN) General Pediatrics Office - Albany, NY Per Diem, minimum 24hrs required ... advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN),...* Performs venipuncture per order of MD/APP * Performs review and triage of incoming test results, patient requests… more
- Albany Medical Center (Albany, NY)
- …own team, manages, and maintains staff assignments, hires and performs employee review , trains, and coaches' staff as needed, develops and reports department ... In conjunction with clinical perioperative leadership, identify standardization and utilization opportunities. + Define business requirements for supplies, implants,… more
- Albany Medical Center (Albany, NY)
- …Responds to changes in work efficiently and effectively. + Support implementation and utilization of clinical nursing research. + Promote the use by colleges and ... and procedures, while engaging in and advocating for succession planning for nurse leaders. + Establishes standards for all department personnel by having… more
- Albany Medical Center (Albany, NY)
- …in scheduling patients for both in person and telehealth visits* Participate in nurse visits including medication review , education and follow-up; patient and ... Day (United States of America) Salary Range: $68.640.00 - $99,023.00 Registered Nurse Pediatric Behavioral/Developmental Office Albany, NY We are looking for a… more
- Albany Medical Center (Albany, NY)
- …Responds to changes in work efficiently and effectively. Support implementation and utilization of clinical nursing research. Promote the use by colleges and ... procedures, while engaging in and advocating for succession planning for nurse leaders. Establishes standards for all department personnel by having criteria-based… more
- Trinity Health (Albany, NY)
- …Skilled Nursing Facilities have a unique opportunity for a RN to receive, review and process referrals of patients at St. Peter's Hospital referred for subacute ... members, referral sources, and external payers regarding the effective and efficient utilization of program services and available resources. + Screening of clients… more
- CDPHP (Albany, NY)
- …(3) years of clinical experience required. + Minimum one (1) year of quality/ utilization review experience required. + Experience with research, data retrieval, ... clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests, render determinations about appropriateness of care,… more