- 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 ... of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
- Ellis Medicine (Schenectady, NY)
- Basic Function: The Utilization Management Registered Nurse (UM RN) supports daily coordination of care across healthcare continuum with the healthcare team, ... responsible for preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures the appropriate level of… more
- Humana (Albany, NY)
- …our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to support ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines and… more
- Albany Medical Center (Albany, NY)
- …Demonstrates experience in the referral process and use of community resources. 2. Utilization Review a. Reviews data from admission screening to clarify ... changing environment. 8. Basic knowledge of computer systems with skills applicable to utilization review process. Mission, Core Values and Service Excellence 1.… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, ... Summary The Albany VAMC is looking to fill (2) Registered Nurse - Community Care Coordinator. Responsibilities The Community Care (CC) Coordinator Registered … more
- New York State Civil Service (Albany, NY)
- …of non-qualifying experience include, but are not limited to, discharge planning, utilization review , treatment plan development for individuals in community or ... NY HELP Yes Agency Health, Department of Title Public Health Program Nurse (NY HELPS) - 24503 Occupational Category Health Care, Human/Social Services Salary Grade… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, ... Albany VAMC is looking to hire 1 - Registered Nurse for our Referral Coordination Team. This position is...to apply! Responsibilities The Referral Coordination Team (RCT) Registered Nurse (RN) is responsible for executing a streamlined approach… 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
- Elevance Health (Latham, NY)
- …4 years managed care experience and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of education ... the Elevance Health major office (PulsePoint) location listed above. The **Medical Management Nurse ** is responsible for review of the most complex or… more
- YesCare Corp (Coxsackie, NY)
- …measures including sentinel event review . + Actively participant of the Utilization Review process and follow proper procedures. + Provides appropriate ... Below is a list of your responsibilities as a ** Nurse Practitioner (NP/ARNP)** withYesCare: + **For this New York...in-service education of staff as requested. Participates in monthly review of quality of care and chart reviews as… more
- Trinity Health (Latham, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Nurse Manager - New Ortho Office - Latham, NY** St. Peter's Health Partners is opening a new ... Ortho Office in Latham. This is an opportunity for an experienced Nurse Manager to start an office and create the systems, within the St. Peter's system. If you are… more
- Elevance Health (Latham, NY)
- **Telephonic Nurse Case Manager II** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and ... in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly...transition of care with Social Worker + Serves as nurse consultant for Social Worker cases with Clinical or… more
- Evolent (Albany, NY)
- …be the single point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work can be divided into ... for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for utilization … more
- Albany Medical Center (Albany, NY)
- …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 We have an ... advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN),...* Performs venipuncture per order of MD/APP * Performs review and triage of incoming test results, patient requests… more
- CenterWell (Clifton Park, NY)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...State requirements. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's… more
- Highmark Health (Albany, NY)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- Albany Medical Center (Albany, NY)
- …own team, manages, and maintains staff assignments, hires and performs employee review , trains, and coaches' staff as needed, develops and reports department ... In conjunction with clinical perioperative leadership, identify standardization and utilization opportunities. + Define business requirements for supplies, implants,… more
- Albany Medical Center (Albany, NY)
- …Responds to changes in work efficiently and effectively. Support implementation and utilization of clinical nursing research. Promote the use by colleges and ... procedures, while engaging in and advocating for succession planning for nurse leaders. Establishes standards for all department personnel by having criteria-based… 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 ... members, referral sources, and external payers regarding the effective and efficient utilization of program services and available resources. + Screening of clients… more