• Remote Utilization Management Review…

    Humana (Albany, NY)
    …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination,… more
    Humana (07/12/24)
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  • Utilization Management Nurse

    CVS Health (Albany, NY)
    …to make health care more personal, convenient and affordable. Position Summary This Utilization Management Nurse Consultant (UMNC) position is a work ... the candidate can live in any state. As a Utilization Nurse Consultant, you will utilize clinical...to coordinate, document and communicate all aspects of the utilization /benefit management program. You would be responsible… more
    CVS Health (08/06/24)
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  • Utilization Behavioral Health Professional

    Humana (Albany, NY)
    …community and help us put health first** Humana Healthy Horizons is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work… more
    Humana (08/06/24)
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  • Registered Nurse 2 (Medical Care)…

    New York State Civil Service (Menands, NY)
    NY HELP Yes Agency Workers' Compensation Board Title Registered Nurse 2 (Medical Care) (NY HELPS), WCB Item #2346 Occupational Category Health Care, Human/Social ... Law.ORCandidates must possess a current license and registration as a registered professional nurse in New York State and two years of registered nursing experience… more
    New York State Civil Service (08/06/24)
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  • Nurse - Referral Coordination Initiative

    Veterans Affairs, Veterans Health Administration (Albany, NY)
    …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community...nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN… more
    Veterans Affairs, Veterans Health Administration (07/31/24)
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  • Inpatient Nurse Case Manager: Mon-Fri, Day…

    Albany Medical Center (Albany, NY)
    …proactively with the Quality Improvement Teams, patient care standards, Social Work, and utilization management to coordinate the appropriate use of resources to ... service. Acute care nursing experience preferred. 4. Recent experience in case management , utilization management and/or discharge planning/home care in… more
    Albany Medical Center (07/17/24)
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  • RN Case Management - Acute Care, Samaritan…

    Trinity Health (Troy, NY)
    …experience in acute setting **Preferred requirements:** + 1+ year of experience in case management or utilization management + Case Management ... **Samaritan Hospital** If you are looking for a position in RN (Registered Nurse ) Case Management in a dynamic hospital, this could be your opportunity. Here at… more
    Trinity Health (07/06/24)
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  • Care Management Associate

    CVS Health (Albany, NY)
    …care more personal, convenient and affordable. Position Summary The Care Management Associate supports comprehensive coordination of medical services including Care ... supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services.… more
    CVS Health (07/26/24)
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  • RN Clinical Manager, Home Health

    CenterWell (Clifton Park, NY)
    …of Nursing. + BSN Required, NY State requirements. + Current state license as a Registered Nurse . + 2 years of Home Health experience with a CHHA required. + ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates...and reliable transportation. + Two years as a Registered Nurse with at least one-year of management more
    CenterWell (07/20/24)
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  • Director of Supply Chain - Procedural Services

    Albany Medical Center (Albany, NY)
    …years in health care, involving benchmarking of data. + Demonstrated progressive management experience, minimum 3-5 years. Skills, Knowledge & Abilities: + Knowledge ... of Workday and Epic is preferred, or knowledge of a similar material management system is required. + Able to communicate effectively at all levels within the… more
    Albany Medical Center (07/30/24)
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  • Case Manager

    Ellis Medicine (Schenectady, NY)
    …for the comprehensive integration of Discharge Planning, Performance Improvement and Utilization Review activities at patient, hospital, and system levels. 2 ... dental staff or hospital department as needed. Ensures that outcome management (data collection through analysis) information is accurate, communicated, and… more
    Ellis Medicine (05/27/24)
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  • Hospital Bill Audit/Appeal Lead

    Elevance Health (Latham, NY)
    …responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment ... + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and procedures. + Investigates potential… more
    Elevance Health (08/08/24)
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  • RN Admission Facilitator

    Trinity Health (Albany, NY)
    …a **bachelor's degree** in nursing from an accredited school and Certified Registered Rehab Nurse preferred (CRRN). + A minimum of 2 years of clinical ... is to provide on-site support and assistance to hospital case management and hospitalist team to ensure timely identification of inpatients appropriate… more
    Trinity Health (08/09/24)
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  • RN Patient Logistics/C3- Per Diem

    Trinity Health (Albany, NY)
    …days during the week **Preferred requirements:** + 1+ year of experience in case management or utilization management + Case Management certification ... an experienced RN to work as a Registered Professional Nurse as part of the C3 Patient Logistics team...and patient satisfaction + Work closely with the Case Management team to insure the patients are processes timey… more
    Trinity Health (06/18/24)
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