- Travelers Insurance Company (Albany, NY)
- …**What Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for ... do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual...to the compensable injury and for adhering to multi-jurisdictional Utilization Review criteria. **What Will You Do?**… more
- Bassett Healthcare (Cobleskill, NY)
- …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co- worker feedback. Analyzes assessment ... cost in managing patient care, as measured by direct supervisory observation and co- worker feedback. Acts effectively as charge nurse , group leader or preceptor… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities The Dialysis Registered Nurse (RN) is a professional nurse with...education, orientation, competencies and providing quality improvement and outcomes utilization . Practice includes directing other providers. Partners with the… more
- Ellis Medicine (Schenectady, NY)
- … Workers (SW). The Discharge Planner's primary function is to work with the Social Worker , Nurse Case Manager, or Utilization Management Nurse to ... utilization management activities under the direction of a registered nurse and/or social worker . Responsibilities include maintaining case files, updating… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and ... in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly...psychosocial needs and coordinate transition of care with Social Worker + Serves as nurse consultant for… more
- Ellis Medicine (Schenectady, NY)
- …for the comprehensive integration of Discharge Planning, Performance Improvement and Utilization Review activities at patient, hospital, and system levels. ... as a RN in New York State. Experience: Previous Utilization Review , Quality Assessment, Discharge Planning or...the systems in which we work. * Serves as nurse consultant for Social Worker cases with… more
- Highmark Health (Albany, NY)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to assure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… more
- CenterWell (Clifton Park, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...State requirements. + Current state license as a Registered Nurse . + 2 years of Home Health experience with… more
- Trinity Health (Albany, NY)
- …record review in collaboration with physicians, nurses, therapists, social workers , case managers and other interdisciplinary team members involved in the ... have a unique opportunity for a RN to receive, review and process referrals of patients at St. Peter's...sources, and external payers regarding the effective and efficient utilization of program services and available resources. + Screening… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability utilization to ensure that clinic schedules ... of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers ,… more