• Utilization Management

    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...to make an impact** **Required Qualifications** + Active licensed Registered Nurse (RN) in the state of… more
    Humana (03/18/25)
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  • 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 healthcare ... preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures...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)
    …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
    CDPHP (03/12/25)
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  • Utilization Management Behavioral…

    Humana (Albany, NY)
    …part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments… more
    Humana (03/15/25)
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  • Registered Nurse - Critical Care…

    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 (03/14/25)
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  • Registered Nurse - Referral…

    Veterans Affairs, Veterans Health Administration (Albany, NY)
    Summary The Albany VAMC is looking to hire 1 - Registered Nurse for our Referral Coordination Team. Responsibilities The Referral Coordination Team (RCT) ... Registered Nurse (RN) is responsible for executing...of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community… more
    Veterans Affairs, Veterans Health Administration (03/21/25)
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  • Registered Nurse

    Veterans Affairs, Veterans Health Administration (Albany, NY)
    …will be considered as vacancies become available. Responsibilities The Staff Registered Nurse (RN) is responsible for providing competent, evidence-based ... 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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  • 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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  • Nurse Case Manager - Full Time, DAYS

    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 ... and develops strategies for variance reduction. Qualifications and Ideal Characteristics 1. Registered nurse with a current license. 2. Bachelor's degree… more
    Albany Medical Center (03/08/25)
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  • Consultant, Nurse Disability

    Lincoln Financial Group (Albany, NY)
    …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's… more
    Lincoln Financial Group (03/22/25)
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  • RN - HIV Medicine Practice

    Albany Medical Center (Albany, NY)
    …Aids Program Work Shift: Day (United States of America) Salary Range: $60,028.00 - $99,023.00 Registered Nurse (RN) - Part Time HIV Medicine Clinic - Albany, NY ... accredited Registered Nursing program is required * Current NYS license as a Registered Nurse is required * Minimum of 1-2 years of prior clinical nursing… more
    Albany Medical Center (02/21/25)
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  • RN-Ambulatory Neurology - Part Time

    Albany Medical Center (Albany, NY)
    …in the establishment of long-term patient care relationships. During each encounter, the registered nurse focuses on patient safety and the quality of nursing ... States of America) Salary Range: $60,028.00 - $99,023.00 The Registered Professional Nurse in the ambulatory setting...utilization of resources to meet patient outcomes (case management ). + Analyzes patient care needs and utilizes a… more
    Albany Medical Center (03/04/25)
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  • AVP - Faculty Practice Nursing

    Albany Medical Center (Albany, NY)
    …Degree in health, business, education, or related field. Must hold current NYS Registered Professional Nurse license. 7-10 years of experience in nursing, ... goals and objectives. As a member of the nursing management team, the AVP of Nursing participates in the...changes in work efficiently and effectively. Support implementation and utilization of clinical nursing research. Promote the use by… more
    Albany Medical Center (12/30/24)
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  • RN Clinical Manager

    CenterWell (Clifton Park, NY)
    …of Nursing. + BSN Required, NY State requirements. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts… more
    CenterWell (02/19/25)
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  • Transition of Care Associate (Must reside in New…

    CVS Health (Albany, NY)
    …You can have life-changing impact on our members, who are enrolled in Care Management and present with a wide range of complex health and social challenges. With ... exciting opportunity as we grow and expand our Care Management Programs to change lives in new markets across...nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN, the TOC Coach ensures the member experiences… more
    CVS Health (03/15/25)
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  • RN - Ob/Gyn Office

    Albany Medical Center (Albany, NY)
    …States of America) Salary Range: $60,028.00 - $99,023.00 Salary range: $68,640 - $99,023 Registered Nurse (RN) Ob/Gyn Office - Albany, NY Work schedule: Monday - ... care. Under the Supervision of the Nursing Supervisor and/or Nurse Manager, the RN provides nursing support to primary...utilization of resources to meet patient outcomes (case management ).* Provides age appropriate direct patient care from the… more
    Albany Medical Center (03/04/25)
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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 ... to provide on-site support and assistance to hospital case management and hospitalist team to ensure timely identification of...accredited school and Certified Registered Rehab Nurse preferred (CRRN). + A… more
    Trinity Health (03/19/25)
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  • Administrative Clinical Supervisor

    Ellis Medicine (Schenectady, NY)
    …EDUCATION AND EXPERIENCE REQUIREMENTS: + Currently licensed in New York State as a Registered Nurse and a graduate of an approved school of nursing. + ... + The Administrative Clinical Supervisor will work collaboratively with the DON and Nurse Managers to assure effective and efficient utilization of staff and… more
    Ellis Medicine (03/05/25)
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  • Product Development Specialist

    Highmark Health (Albany, NY)
    …organizational systems **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + Registered Dietician + Registered Nurse **EDUCATION** **Required** ... clinical initiatives/programs to the customer audiences through effective project management , collaboration and application of best practices and engagement.… more
    Highmark Health (03/21/25)
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  • Clinical Appeals Specialist

    CDPHP (Albany, NY)
    …grievances, NYS external review, and making recommendations for change. QUALIFICATIONS: + Registered Nurse , Physician Assistant or Nurse Practitioner, with ... years of clinical experience required. + Minimum one (1) year of quality/ utilization review experience required. + Experience with research, data retrieval, data… more
    CDPHP (03/20/25)
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