• Utilization Management Nurse

    CVS Health (Albany, NY)
    …weeks of training will be Monday through Friday, 8:00am to 5:00pm EST. As a Utilization Management Nurse Consultant you will utilize clinical experience and ... of residence + 3+ years of experience as a Registered Nurse + 1+ year(s) of Med/Surg...to 7:00pm EST with holiday rotation per business needs. Utilization Management is a 24/7 operation and… more
    CVS Health (01/17/25)
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  • Utilization Management RN

    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
    Ellis Medicine (01/02/25)
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  • Utilization Management Review…

    Humana (Albany, NY)
    …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) with no… more
    Humana (01/20/25)
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  • RN Case Management - Acute Care,…

    Trinity Health (Troy, NY)
    …through Friday** **Samaritan Hospital** If you are looking for a position in RN ( Registered Nurse ) Case Management in a dynamic hospital, this could be ... member of our caring, compassionate health care team the RN Case Manager will enjoy: Tuition assistance Great shift...**Preferred requirements:** + 1+ year of experience in case management or utilization management +… more
    Trinity Health (01/03/25)
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  • RN Case Management (C3) - for ACUTE…

    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
    Trinity Health (01/18/25)
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  • RN Case Management - Acute Care,…

    Trinity Health (Troy, NY)
    …through Friday - Samaritan HospitalIf you are looking for a position in RN ( Registered Nurse ) Case Management in a dynamic hospital, this could be your ... member of our caring, compassionate health care team the RN Case Manager will enjoy: Tuition assistance Great shift...in acute settingPreferred requirements:1+ year of experience in case management or utilization managementCase Management more
    Trinity Health (12/26/24)
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  • Care Manager RN - Weekends (Remote)

    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
    Highmark Health (01/07/25)
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  • Registered Nurse

    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 (01/18/25)
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  • Registered Nurse - Dialysis

    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
    Veterans Affairs, Veterans Health Administration (11/17/24)
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  • Care Manager Behavioral Health - Part Time…

    Highmark Health (Albany, NY)
    …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** +… more
    Highmark Health (12/12/24)
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  • Case Manager (Inpatient Units)

    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
    Ellis Medicine (12/13/24)
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  • Prior Authorization Specialist RN PRN

    Intermountain Health (Albany, NY)
    …REGISTRATION, LICENSE (*indicates primary source verification requirement) Required: + Active Registered Nurse License Preferred: + Certified Healthcare Access ... Associate (CHAA) EXPERIENCE Required: + Licensed Registered Nurse + Minimum of 2 years'...experience in acute clinical nursing setting + Knowledge of utilization management and case management more
    Intermountain Health (01/18/25)
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  • Nurse Reviewer I

    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
    Elevance Health (01/17/25)
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  • RN Patient Logistics - M-F FT @St Peters…

    Trinity Health (Albany, NY)
    …Hospital in Albany, NY** is looking for an experienced RN to work as a Registered Professional Nurse as part of the C3 Patient Logistics team full time days. ... of our caring, compassionate health care professionals the **selected RN ** will enjoy: + Great shift differentials + Be...**Preferred requirements:** + 1+ year of experience in case management or utilization management +… more
    Trinity Health (12/31/24)
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  • RN - Stroke Nurse Navigator

    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
    Albany Medical Center (01/11/25)
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  • Medicaid Special Programs Case Manager

    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
    CDPHP (12/12/24)
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  • RN -Education Spec-Clin Center for Learning…

    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
    Albany Medical Center (12/01/24)
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  • RN Clinical Manager, Home Health

    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
    CenterWell (10/30/24)
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  • LTSS Service Coordinator - RN Telehealth

    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
    Elevance Health (01/08/25)
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  • RN Clinical Consultant, Claims Shared…

    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
    Guardian Life (12/20/24)
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