- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- CenterWell (Albany, NY)
- …clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Intelligence + ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...Experience with Home Health preferred + Previous experience in utilization management within Insurance industry a plus… 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 (Latham, 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
- Molina Healthcare (Albany, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… 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 ... principles of Patient Centered Medical Home (PCMH), the Care Manager ( RN ) will demonstrate professional nursing practice, excellent communication and critical… more
- Oneonta Job Corps (Oneonta, NY)
- …Microsoft Suite (Word, Excel, Outlook, PowerPoint.) Educational Requirements: + State Licensed Registered Nurse . + Three years' experience as a practicing ... in nurses' on-call rotation. + Function as a staff nurse as needed. + Collect data and maintain wellness...as needed. + Collect data and maintain wellness monthly Utilization Reports. + Plan, organize, and control the use… 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 ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports… more
- Albany Medical Center (Albany, NY)
- …knowledge of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or Compact State ... works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to… more
- Molina Healthcare (Albany, NY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Bassett Healthcare (Cobleskill, NY)
- …needs. The RN contributes to the support of patients through interdisciplinary teamwork. + Registered Nurse I: The RN I status is only appropriate for a ... + Salary Range: $39.01 - $58.51 per hour + Registered Nurse II: The RN ...or be suspended at any time. Bonus Amount: + RN (excluding management ) sign-on bonuses are awarded… more
- MVP Health Care (Schenectady, NY)
- …of clinical nursing experience + At least 2 years of experience in utilization management of sub-acute Medicare reviews + Experience with Medicare guidelines ... and continuous improvement. To achieve this, we're looking for a **Professional, Sub-Acute RN UM Reviewer - Medicare** to join #TeamMVP. If you have a passion… more
- Bassett Healthcare (Cooperstown, NY)
- …experience as a Registered Nurse , if experience is not relevant, Registered Nurse II must complete RN residency program, required License/ ... Certification: + Current NYS license as a Registered Nurse , required + BLS certification will...or be suspended at any time. Bonus Amount: + RN (excluding management ) sign-on bonuses are awarded… more
- Bassett Healthcare (Cooperstown, NY)
- …Experience: + New graduate or less than one year of experience as a Registered Nurse , required License/ Certification: + NYS licensure as Registered ... best quality of life possible. What you'll do The Registered Professional Nurse I, Acute Care is...or be suspended at any time. Bonus Amount: + RN (excluding management ) sign-on bonuses are awarded… more
- Bassett Healthcare (Delhi, NY)
- …before 12/19/17 are/remain exempt from this requirement. Experience: + Minimum 5 years of Registered Nurse experience, 3 years must be in relevant practice area, ... to perform as preceptor, required + Minimum 2 years Registered Nurse experience in relevant practice area,...or be suspended at any time. Bonus Amount: + RN (excluding management ) sign-on bonuses are awarded… more
- Molina Healthcare (Albany, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical...member care. The candidate must have Medicare Appeals and/or Utilization Management knowledge. Work hours are Monday-Friday… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… 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
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …application. Former EDRP participants ineligible to apply. Responsibilities The Inpatient Staff Registered Nurse ( RN ) is responsible for providing competent, ... 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
- Ellis Medicine (Schenectady, NY)
- …Services discharge planning guidelines and departmental/organizational policies and processes + Utilization Management : + Ensures order in chart/EMR coincides ... RN Case Manager has responsibility for case management of assigned patients on a designated unit(s). This...the Case Manager include, but are not limited to, utilization review, case management , care transition, collaboration… more