- Evolent (Albany, NY)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Molina Healthcare (Albany, NY)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring ... Michigan RN license is required. **Job Duties** + Facilitates clinical / medical reviews of retrospective medical ...nursing experience, including at least 1 year of utilization review , medical claims review , long-term… more
- Albany Medical Center (Albany, NY)
- …study mediation to the patient or set up/schedulemedication infusions or coordinate with nurse to administer study medication injection. 16. Review oral study ... Diem (United States of America) Salary Range: $78,773.63 - $122,099.12 The clinical research coordinator is responsible for the organization and management of… more
- Albany Medical Center (Albany, NY)
- …and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and contacts ... improvement in both areas.* Refers cases and issues to Medical Director and Triad Team in compliance with Department...payor criteria and issues and a case-by-case basis with clinical staff and follows up to resolve problems with… more
- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests ... Central time Remote position **Essential Job Duties** * Performs clinical / medical reviews of previously denied cases in...specific programs supported by the plan such as utilization review , medical claims review , long-term… more
- Albany Medical Center (Albany, NY)
- …invasive procedures to evaluate their physical and emotional readiness. + Review patients' medical histories, including pre-existing conditions, allergies, ... Day (United States of America) Salary Range: $0.00 - $0.00 A Pre-Admission Testing Nurse plays a crucial role in ensuring the safe and efficient preparation of… more
- CDPHP (Latham, NY)
- …The Utilization Review (UR) Nurse is responsible for the clinical review and documentation for services requiring prior authorization. This includes ... Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
- Trinity Health (Rensselaer, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** Nurse - RNII - Family Medical Group- Rensselaer If you are looking for an RN II position, ... Office hours What you will do: The Registered Professional Nurse has the responsibility and accountability to utilize the...room, takes appropriate vital signs and documents in electronic medical record. Review and update medication list… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Senior Registered Nurse - Outpatient Medical Oncology - St. Peter's Hospital Full time - 4 ... Brings patient to exam room, takes appropriate vital signs and documents in electronic medical record. + Review and update medication list to ensure accurate and… more
- Albany Medical Center (Albany, NY)
- …environment. + Basic knowledge of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or ... management to coordinate the appropriate use of resources to achieve maximum clinical and financial outcomes. The Case Manager participates in maintaining quality… more
- Albany Medical Center (Albany, NY)
- …$0.00 - $0.00 Position Summary We are seeking a dedicated and compassionate Nurse Practitioner (NP) to join our academic home-based primary care practice, serving ... home visits, telehealth support, and the management of chronic and acute medical conditions, with a strong emphasis on geriatric syndromes, care coordination, and… more
- Fresenius Medical Center (Albany, NY)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
- IQVIA (Albany, NY)
- Mobile Nurse Practitioner - Per Diem, In-Home Services **Location:** Various US locations (local travel within designated geographic area) **About the Role:** ... IQVIA's In-Home Clinical Solutions team seeks a qualified and dedicated Mobile Nurse Practitioner to support patient care by delivering in-home diagnostic… more
- Trinity Health (Albany, NY)
- …Cardiology Office - Albany, NY - FT - Days** If you are looking for a Clinical Nurse Manager position in an Outpatient Cardiology practice, this could be your ... allowance and career development **What you will do:** The Nurse Manager of Clinical Care is directly...ACLS certification + Minimum of ten years demonstrated professional clinical leadership. + Significant electronic medical record… more
- CVS Health (Albany, NY)
- …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
- CenterWell (Pittsfield, MA)
- …policies and standards. + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by ... on-site at our Pittsfield, MA branch location.** The **RN Clinical Manager** coordinates and oversees all direct care patient...Utilization Review staff. Upon completion of the assessment, creates and… more
- Datavant (Albany, NY)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
- New York State Civil Service (Claverack, NY)
- …medication administrationMaintain inventory standards for medication, controlled substances, medical supplies.Participate in staff trainingPrepare clinical and ... summaries.Provide medication administrationMaintain inventory standards for medication, controlled substances, medical supplies.Participate in staff trainingPrepare clinical and… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …and record relevant] patient information. Completed work [should need] only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness ... condition, collecting objective and subjective data. Collaborating with the Registered Nurse /Provider in developing and implementing a plan of care individualized to… 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 ... insurance and more! GENERAL RESPONSIBILITIES: Using principles of Patient Centered Medical Home (PCMH), the Care Manager (RN) will demonstrate professional nursing… more