- Veterans Affairs, Veterans Health Administration (Albany, NY)
- … Nurse - Community Care Coordinator. Responsibilities The Community Care (CC) Coordinator Registered Nurse ( RN ) is responsible for executing a streamlined ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Highmark Health (Albany, NY)
- …Highmark Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of ... + Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse ( RN ) license + Delaware RN … more
- Humana (Albany, NY)
- …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in the state of Virginia or ... licensure + Previous Medicare/Medicaid experience a plus + Previous experience in utilization management , case management , discharge planning and/or home… more
- 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 (Albany, NY)
- …application. Former EDRP participants ineligible to apply. Responsibilities The Inpatient Staff Registered Nurse ( RN ) is responsible for providing competent, ... orientation, competencies and providing quality improvement and enhance outcomes utilization . This nurse integrates knowledge, skills, abilities,...level degree in Nursing may have opportunity to become registered as a nurse with a state… 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 ... acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge of… more
- Elevance Health (Latham, NY)
- …commute to the Elevance Health major office (PulsePoint) location listed above. The **Medical Management Nurse ** is responsible for review of the most ... **Medical Management Nurse ** **Office Location** : Atlanta,...experience and requires a minimum of 2 years clinical, utilization review , or case management … 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
- 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 (Albany, NY)
- …of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines… more
- 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, ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...program is required * Current NYS license as a Registered Nurse is required * Minimum of… more
- 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 ... Skilled Nursing Facilities have a unique opportunity for a RN to receive, review and process referrals...accredited school and Certified Registered Rehab Nurse preferred (CRRN). + A… more
- Evolent (Albany, NY)
- …+ Performs other duties as assigned. **Qualifications: Required and Preferred:** + Licensed registered nurse or LVN/LPN (current and unrestricted) + Minimum of ... refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately identifies potential cases...patient care + **Minimum one year of experience with Utilization Review (UM) in a managed care… 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
- Sedgwick (Albany, NY)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Medicare Compliance **We are growing and looking for nurses who have their ... clinical data; to complete complex submissions revisions/updates in preparation for Medicare review and act as an internal resource regarding Centers for Medicare &… more
- New York State Civil Service (Albany, NY)
- …packages such as Microsoft Office, Outlook, etc. Additional Comments Current registration as a Registered Nurse ( RN ) with the New York State Education ... New York State license and registration as a professional registered nurse AND four years of post-licensure...experience include, but are not limited to, discharge planning, utilization review , treatment plan development for individuals… more
- Elevance Health (Latham, NY)
- …following standard procedures that do not require the training or skill of a registered nurse . **How you will make an impact** Primary duties include, but ... **Medical Management Clinician Associate** **Location:** The ideal candidate will...a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid… more
- 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 ... the referral process and use of community resources. 2. Utilization Review a. Reviews data from admission...strategies for variance reduction. Qualifications and Ideal Characteristics 1. Registered nurse with a current license. 2.… more
- CVS Health (Albany, NY)
- …visit, inpatient, skilled nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN , the TOC Coach ensures the member experiences a ... impact on our members, who are enrolled in Care Management and present with a wide range of complex...or changes in condition to be transitioned back to RN . + Complete post discharge call and required assessments… more