- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Sharecare (Albany, NY)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...the disease management program intervention guidelines. An RN is supervised by an Operations Manager (OM). All… more
- 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 registered nurse dialysis experience Caring for acute, chronic and peritoneal dialysis… more
- Highmark Health (Albany, NY)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- Elevance Health (Latham, NY)
- …Service Coordinator - RN Telehealth** _Location:_ While this position is fully remote , candidate must reside in the tri-state area (NY, NJ, or CT) and within ... 50 miles of a PulsePoint. The **LTSS Service Coordinator - RN Telehealth** is responsible for overall management of member's case within the scope of licensure;… more
- Guardian Life (Albany, NY)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
- Highmark Health (Albany, NY)
- … - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** +… more
- United Therapeutics (Albany, NY)
- …Degree preferably in a health, biological sciences, or related field or + Registered Nurse ( RN ) nursing qualifications or relevant clinical research ... with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was… more
- Elevance Health (Latham, NY)
- …Health location. The ** Nurse Case Manager ll** is responsible for care management within the scope of licensure for members with complex and chronic care needs ... providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** Requires BA/BS… more
- J&J Family of Companies (Albany, NY)
- …Immunology work experience Must be familiar with Microsoft Word, Excel, PowerPoint, and utilization of computers and remote technologies Reside in or near the ... identified OLs and health care providers (MD, PA, NP, RN , Pharm.D., biocoordinators) and developing and managing a geographical...their skills and agility, applying the competencies of Change Management , Time Management and Innovation. The MSL… more