• Utilization Management RN

    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
    Ellis Medicine (01/02/25)
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  • Utilization Review Nurse

    CDPHP (Albany, NY)
    …as a Licensed Practical Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge of coding/claims processing 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 or Licensed Practical Nurse more
    CDPHP (01/24/25)
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  • RN Case Management - Acute Care, St.…

    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:** Day Shift **Description:** ** RN Case Manager** **Full-Time Days** **St. Peter's Hospital**...Engage the patient and care team in the joint management of key patient outcomes such as management more
    Trinity Health (01/31/25)
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  • RN Compliance Auditor

    Humana (Albany, NY)
    …part of our caring community and help us put health first** The Compliance Nurse Auditor reviews utilization management activities and documentation to ... to prevent and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality Assurance Audit...care, skilled and/or rehabilitation clinical setting + Experience with utilization management , pre-service denials and/or quality assurance… more
    Humana (01/31/25)
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  • Registered Nurse - Dialysis

    Veterans Affairs, Veterans Health Administration (Albany, NY)
    …of the EDRP application. Former EDRP participants ineligible to apply. Responsibilities The Dialysis Registered Nurse ( RN ) is a professional nurse with ... BSN 3-5 Years Med/Surg or Critical Care experience At least 1 year of recent registered nurse dialysis experience Caring for acute and , chronic Hemodialysis and… more
    Veterans Affairs, Veterans Health Administration (02/01/25)
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  • Registered Nurse

    Veterans Affairs, Veterans Health Administration (Albany, NY)
    …candidates will be considered as vacancies become available. Responsibilities The Staff Registered Nurse ( RN ) is responsible for providing competent, ... and decision-making, deliberate planning, and critical thinking skills. The duties of the Registered Nurse include but are not limited to: Independently plans… more
    Veterans Affairs, Veterans Health Administration (02/01/25)
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  • Case Manager (Inpatient Units)

    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
    Ellis Medicine (01/24/25)
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  • Clinical Reviewer, Nurse

    Evolent (Albany, NY)
    …Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts...and Preferred:** + Current, unrestricted state licensure as a Registered Nurse - **Required** + Associate or Bachelors… more
    Evolent (02/05/25)
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  • Dialysis Charge Registered Nurse

    Fresenius Medical Center (Albany, 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 (01/24/25)
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  • RN - Stroke Nurse Navigator

    Albany Medical Center (Albany, NY)
    …and resolution of the barriers to discharge in collaboration with social work, utilization management , home health care, care team and family to facilitate ... to improve patient care and outcomes. Qualifications and Ideal Characteristics + Registered nurse with a current license in New York State. + Bachelor's degree… more
    Albany Medical Center (01/11/25)
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  • Medicaid Special Programs Case Manager

    CDPHP (Albany, NY)
    …Programs RN Case Manager and the success of the member-focused Complex Case Management Programs. Qualifications: + Registered Nurse with a current New ... a part of that experience. The Medicaid Special Programs Registered Nurse Case Manager is responsible and...Care Programs preferred. + Minimum of two (2) years Utilization Management experience is preferred. + Experience… more
    CDPHP (12/12/24)
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  • Senior Nursing Educator

    Humana (Albany, NY)
    …Training programs may include, but not be limited to, Care Management , Utilization Management , and/or Compliance. RN licensure is required at all ... + Master of Science in Nursing with a focus on nursing education. + Licensed Registered Nurse ( RN ) in the state where you reside with no disciplinary action… more
    Humana (01/28/25)
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  • RN -Education Spec-Clin Center for Learning…

    Albany Medical Center (Albany, NY)
    …the field of Clinical Social Work or Nursing with experience in Case Management , Utilization Review and Discharge Planning. * BLS Certification. * Demonstrated ... principles of conflict resolution and promote consensus building.* Represents Case Management /Social Work at organizational committee meetings as directed* Serves as… more
    Albany Medical Center (12/01/24)
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  • RN Clinical Manager, Home Health

    CenterWell (Clifton Park, NY)
    …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... health first** **$10,000 Sign on Bonus! Immediate Benefits!** The ** RN ** **Clinical Manager** coordinates and oversees all direct care...NY State requirements. + Current state license as a Registered Nurse . + 2 years of Home… more
    CenterWell (01/29/25)
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  • RN - Women's Health Clinic

    Albany Medical Center (Albany, NY)
    …of America) Salary Range: $60,028.00 - $99,023.00 Salary range: Min $68,640 - Max $99,023 Registered Nurse ( RN ) Ob/Gyn Office - Albany, NY Work schedule: ... NSTs Under the Supervision of the Nursing Supervisor and/or Nurse Manager, the RN provides nursing support...utilization of resources to meet patient outcomes (case management ).* Provides age appropriate direct patient care from the… more
    Albany Medical Center (01/31/25)
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  • RN Admissions Facilitator - Skilled Nursing…

    Trinity Health (Albany, NY)
    …other related duties as assigned Experience and Requirements + Active Licensure as a registered nurse , preferably with a **bachelor's degree** in nursing from an ... **Employment Type:** Full time **Shift:** Day Shift **Description:** RN ADMISSION FACILITATOR EDDY SKILLED NURSING FACILITIES (located...accredited school and Certified Registered Rehab Nurse preferred (CRRN). + A… more
    Trinity Health (01/28/25)
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  • RN -Ambulatory

    Albany Medical Center (Albany, NY)
    …Salary range: $68,640 - $99,023 Under the Supervision of the Nursing Supervisor and/or Nurse Manager, the RN provides nursing support to primary and subspecialty ... utilization of resources to meet patient outcomes (case management ). + Analyzes patient care needs and utilizes a...Registered Nursing program is required + NYS current RN licensure to practice professional nursing is required +… more
    Albany Medical Center (12/30/24)
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  • RN -Ambulatory

    Albany Medical Center (Albany, NY)
    …- $99,023.00 Position Summary Under the Supervision of the Nursing Supervisor and Nurse Manager, the RN Ambulatory provides nursing support to primary and ... in planning, directing, providing and evaluating patient care. The RN Ambulatory is defined within the department to provide...utilization of resources to meet patient outcomes (case management ). + Analyzes patient care needs and utilizes a… more
    Albany Medical Center (01/31/25)
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  • RN Medicare Compliance

    Sedgwick (Albany, NY)
    …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Medicare Compliance **PRIMARY PURPOSE** **:** To provide professional assessment, ... final determination based on applicable coverage policies, coding guidelines and utilization and practice guidelines. + Reviews medical claims and completes complex… more
    Sedgwick (01/29/25)
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  • RN -Manager - FT-Sunnyview Rehab…

    Trinity Health (Schenectady, NY)
    …preferred or obtained within 2 years of hire. + Previous experience in nurse management required Our compassionate staff is there with up-to-the-minute treatment ... Director of Nursing. ​ **What you will need:** + Current New York State Registered Professional Nurse licensure (The Program Nurse Manager requires… more
    Trinity Health (11/26/24)
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