- Elevance Health (Latham, NY)
- RN Utilization Management - Case Management (Medicaid Long Term Care) JR155671 **Location** : New York or New Jersey. **Virtual:** This role enables ... face-to-face onboarding and skill development as needed. The **Medical Management Nurse ** is responsible for review of...and Experiences:** + A combination of utilization review/ utilization management and Case … more
- Albany Medical Center (Albany, NY)
- …of three years clinical experience in an assigned service.* Recent experience in case management , utilization management and/or discharge planning/home ... of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay ...with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State… more
- Trinity Health (Troy, NY)
- …through Friday - Samaritan HospitalIf you are looking for a position in RN ( Registered Nurse ) Case Management in a dynamic hospital, this could ... member of our caring, compassionate health care team the RN Case Manager will enjoy: Tuition assistance...experience in acute settingPreferred requirements:1+ year of experience in case management or utilization managementCase… more
- CVS Health (Albany, NY)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- CVS Health (Albany, NY)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year...keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Albany Medical Center (Albany, NY)
- …in an assigned service. Acute care nursing experience preferred.4. Recent experience in case management , utilization management and/or discharge ... proactively with the Quality Improvement Teams, patient care standards, Social Work, and utilization management to coordinate the appropriate use of resources to… more
- Molina Healthcare (Albany, NY)
- …authorization requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference ... **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States...meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience**… more
- Baylor Scott & White Health (Albany, NY)
- **LOCATION:** Remote **SPECIALTY/DEPARTMENT:** Care Management : Case Management Utilization Management Appeals or grievances **SHIFT/SCHEDULE:** ... (2) two years of pertinent experience is essential. + ( RN ) Registered Nurse license and...EXPERIENCE IN ONE OR MORE OF THE FOLLOWING SPECIALITIES:** ** Case Management ** ** Utilization Management… more
- Albany Medical Center (Albany, NY)
- …Aids Program Work Shift: Day (United States of America) Salary Range: $60,028.00 - $99,023.00 Registered Nurse ( RN ) - Full time HIV Medicine Clinic - Albany, ... offers comprehensive HIV services including primary medical care, medical case management , medication adherence, peer services, substance...Nursing program is required* Current NYS license as a Registered Nurse Thank you for your interest… more
- Albany Medical Center (Albany, NY)
- …Experience in the field of Clinical Social Work or Nursing with experience in Case Management , Utilization Review and Discharge Planning. * BLS ... Demonstrate principles of conflict resolution and promote consensus building.* Represents Case Management /Social Work at organizational committee meetings as… more
- Elevance Health (Latham, NY)
- …The **LTSS Service Coordinator - RN Telehealth** is responsible for overall management of member's case within the scope of licensure; provides supervision ... and direction to non- RN clinicians participating in the member's case ...chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management , or similar role; or any… more
- Molina Healthcare (Albany, NY)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
- Albany Medical Center (Albany, NY)
- …department. + Facilitates the utilization of resources to meet patient outcomes ( case management ). + Analyzes patient care needs and utilizes a systematic ... States of America) Salary Range: $60,028.00 - $99,023.00 Urogynecology Nurse ( RN ) Division of Urogynecology within the...Registered Nursing program is required + NYS current RN licensure to practice professional nursing is required +… more
- Highmark Health (Albany, NY)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... , identification of opportunities for referral to a Health Coach/ case management , and identification and resolution of...clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS**… more
- Albany Medical Center (Albany, NY)
- …WIC + Facilitates the utilization of resources to meet patient outcomes ( case management ). + Writes letters of medical necessity as indicated + Participates ... required. Under the supervision of the Nursing Supervisor and Nurse Manager, the Ambulatory Care RN provides...following. Other related duties may be assigned: Support for Self- Management + Enhances health literacy + Performs a baseline… more
- Sedgwick (Albany, NY)
- …and client satisfaction; to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for ... business lines; and to provide expertise in client specific case management and utilization review...promote maximum performance. **QUALIFICATIONS** **Education & Licensing** Current unrestricted RN license in a state or territory of the… more
- Albany Medical Center (Albany, NY)
- …and accurately. The Core Tech will support an integrated SPD/Sterile core/Supply Chain Management function in the operating room. Functions in the OR setting under ... the direction of the OR RN clinical manager(s). Assures surgeons' needs as identified on...as a liaison between the Surgery departments, SPD, Materials Management , and Clinical Engineering departments as necessary to assure… more
- CVS Health (Albany, NY)
- …TOC team will review prior claims to address potential impact on current case management and eligibility status. Focus assessments and/or questionnaires are ... impact on our members, who are enrolled in Care Management and present with a wide range of complex...nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN , the TOC Coach ensures the… more
- Albany Medical Center (Albany, NY)
- …to interpret real-time data to drive decision-making (High proficiency) + RN /MD/DO/MBBS/Paramedic/ Case Management /Social Work Prior or Current ... of admissions via all portals of entry, transfers, bed management , and overall throughput. Hourly Range: $38.53 - $63.58...work within and with large teams (High proficiency) + Utilization and data entry into EMR and technology (High… more