- Trinity Health (Albany, NY)
- …requirements for Utilization Management and works collaboratively with Utilization Management /Concurrent Review Nurse , physicians, staff and ... Upon identification of possible concurrent denials, forwards information to the appropriate Utilization Management /Concurrent Review Nurse within… more
- CDPHP (Albany, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… 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
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …education, orientation, competencies and providing quality improvement and enhance outcomes utilization . This nurse integrates knowledge, skills, abilities, and ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- Evolent (Albany, NY)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… more
- Albany Medical Center (Albany, NY)
- …years in health care, involving benchmarking of data. + Demonstrated progressive management experience, minimum 3-5 years. Skills, Knowledge & Abilities: + Knowledge ... of Workday and Epic is preferred, or knowledge of a similar material management system is required. + Able to communicate effectively at all levels within the… more
- Albany Medical Center (Albany, NY)
- …of short and long-term goals and objectives. As a member of the nursing management team, the AVP of Nursing participates in the efficient and effective management ... ensure compliance with all regulatory standards. Planning and Program Management Provides administrative direction and coordination in the formulation,… more
- CDPHP (Albany, NY)
- …with Medicaid Long Term Care Programs preferred. + Minimum of two (2) years Utilization Management experience is preferred. + Experience with the New York State ... Programs RN Case Manager and the success of the member-focused Complex Case Management Programs. Qualifications: + Registered Nurse with a current New York… more
- Trinity Health (Albany, NY)
- …Skilled Nursing Facilities have a unique opportunity for a RN to receive, review and process referrals of patients at St. Peter's Hospital referred for subacute ... is to provide on-site support and assistance to hospital case management and hospitalist team to ensure timely identification of inpatients appropriate… more
- CDPHP (Albany, NY)
- …(3) years of clinical experience required. + Minimum one (1) year of quality/ utilization review experience required. + Experience with research, data retrieval, ... clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests, render determinations about appropriateness of care,… more
- United Therapeutics (Albany, NY)
- …with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was ... on behalf of UTC + Attain a thorough understanding of site management tasks and responsibilities necessary to implement compliance with the protocol, applicable… 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