- CVS Health (Albany, NY)
- …active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing… more
- CVS Health (Albany, NY)
- …in the state of residence (LMSW, LCSW, LISW, LPC, or comparable) or Registered Nurse licensure with psychiatric specialty, certification, or experience in state ... Monday through Friday 8:30-5pm EST. No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral… more
- Ellis Medicine (Schenectady, NY)
- Basic Function: The Utilization Management Registered Nurse (UM RN ) supports daily coordination of care across healthcare continuum with the ... preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN...care related field required. Current registration as a Licensed Registered Professional Nurse in New York State.… more
- CVS Health (Albany, NY)
- …day. This is a full-time remote position. **Position Summary** Precertification (Infertility): Utilization Management Nurse Consultant + Utilizes clinical ... management function. **Required Qualifications** + 3+ years of acute experience as a Registered Nurse + Must have active current and unrestricted RN … more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure ... skills to make an impact** **Required Qualifications** + Active Registered Nurse license in a state that...one, (1), year of experience auditing and/or performing case management or utilization management chart… more
- CVS Health (Albany, NY)
- …is fully meeting all metrics._** **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN ... applications (Outlook, Teams, Excel) **Preferred Qualifications** + Prior authorization or Utilization Management experience + Managed care experience +… more
- Albany Medical Center (Albany, NY)
- …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG...with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State… more
- CDPHP (Albany, NY)
- …Minimum two (2) years of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York… more
- CVS Health (Albany, NY)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...Pharmacy or Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- CVS Health (Albany, NY)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year...using a keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Saratoga Hospital (Saratoga Springs, NY)
- …criteria to identify severity of illness & intensity of service for appropriate utilization management and 1st level criteria reviews. Documents required data in ... the Collaborative Practice Groups, Magnet Councils, Interdisciplinary Committees and/or Utilization Management Committee. Develops and implements interdisciplinary… more
- Trinity Health (Albany, NY)
- …experience in acute setting **Preferred requirements:** + 1+ year of experience in case management or utilization management + Case Management ... **Employment Type:** Full time **Shift:** Evening Shift **Description:** ** RN Case Manager** **Full-Time Eves - 8hrs 3p-11p**...Engage the patient and care team in the joint management of key patient outcomes such as management… more
- Baylor Scott & White Health (Albany, NY)
- …relevant field. + At least (2) two years of pertinent experience is essential. + ( RN ) Registered Nurse license and (BLS) Basic Life Support certification. If ... **LOCATION:** Remote **SPECIALTY/DEPARTMENT:** Care Management : Case Management Utilization ...based on position type and/or level **Job Summary** A Registered Nurse in Nursing Professional Development Generalist… more
- MVP Health Care (Schenectady, NY)
- Hospital Case Manager - Registered Nurse ( RN ) 625 State St, Schenectady, NY 12305, USA Req #2261 Monday, May 19, 2025 At MVP Health Care, we're on a mission ... bring:** + Current New York State Licensure as a Registered Nurse required with at least 4...at least 4 years of recent clinical and Care Management experience. + Certification in Case Manager (CCM) is… 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 be your ... member of our caring, compassionate health care team the RN Case Manager will enjoy: Tuition assistance Great shift...in acute settingPreferred requirements:1+ year of experience in case management or utilization managementCase Management … more
- Fresenius Medical Center (Schenectady, NY)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... quality of patient care, as defined by the quality goals, by working with management to ensure that policies and procedures are followed. + Assists with implementing… more
- Fresenius Medical Center (Saratoga Springs, NY)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- Ellis Medicine (Schenectady, NY)
- …+ Candidates must have a minimum of 2-3 years leadership experience in Case Management , Utilization Management and/or Quality Assessment, or a minimum of ... oversees appropriate response + Responsible for coordination of processes including Utilization Management (UM), meetings, Committee reports, functions and… more
- Sharecare (Albany, NY)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... according to the disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations Manager (OM). All Sharecare… more
- Molina Healthcare (Albany, NY)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… more