- 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
- Baylor Scott & White Health (Albany, NY)
- …of staff, resource management , and budget control. Departments involved are Utilization Management , Case Management , and Disease Management . ... Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- 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 Management (C3)** **Full-Time - Monday-Friday** **St. Peter's or Samaritan… 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
- 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
- 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 (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
- 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
- Elevance Health (Latham, NY)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... required. **Preferred Skills, Capabilities, and Experiences** **:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… more
- 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
- 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
- Elevance Health (Latham, NY)
- …providers, claims, or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires ... ** Nurse Case Manager I - NICU** **Location:** **This...a timely fashion. + Knowledge of health insurance/benefits, medical management process, care management , and utilization… more
- Humana (Albany, NY)
- …your skills to make an impact** **Required Qualifications** + Associate degree + Active Registered Nurse , ( RN ), License in your state of residence without ... management and/or process improvement experience + Minimum 3 years utilization management experience with exposure to grievance and appeals + Proficient in… more
- 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
- 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
- Elevance Health (Latham, NY)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This is a...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Latham, NY)
- …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 ... **LTSS Service Coordinator - RN Telehealth** _Location:_ While this position is fully remote, candidate must reside in the tri-state area (NY, NJ,… 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
- 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 (Albany, NY)
- …and healthcare statistical data. + Ability to demonstrate trends/findings using statistical tools. + RN - Registered Nurse - State Licensure and/or Compact ... which analyze productivity and cost benefit, and related fiscal management and personnel utilization to objectives and...State Licensure Must hold current NYS Registered Nurse license. Upon Hire - preferred… more