- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… 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)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Highmark Health (Albany, NY)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- Albany Medical Center (Albany, NY)
- …in the field of Clinical Social Work or Nursing with experience in Case Management , Utilization Review and Discharge Planning. * BLS Certification. * ... principles of conflict resolution and promote consensus building.* Represents Case Management /Social Work at organizational committee meetings as directed* Serves as… more
- WMCHealth (Kingston, NY)
- …Implement policies and procedures, service delivery standards, quality assurance and utilization review standards, and Kingston Hospital nursing division ... RN - Methadone Clinic Company: HealthAlliance Hospital City/State: Kingston,...chemically dependent patients preferred + Training/License: + Current NYS Registered Nurse + Other: + N/A About… 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...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… 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
- 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
- Mental Health Association in Ulster County, Inc. (Kingston, NY)
- …one year of employment* Overview MHA in Ulster County, Inc. seeks a Full-Time Registered Nurse to work in our Assertive Community Treatment Team (ACT Program) ... met. + Participate in ACT Treatment Team meetings, Incident Review meetings, Utilization Review meetings,...and Skills + A license to practice as a Registered Professional Nurse in New York State.… 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 ... license in applicable state(s) required. **Preferred Qualifications:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… more
- OrthoNY (Albany, NY)
- …and is accountable for the quality of nursing care. + Responsible for management of Physician block/surgery time; evaluates block utilization and makes ... is responsible for strategic planning, budgeting, regulatory compliance, and performance management , ensuring the highest standards of patient care and operational… 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