- 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
- 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
- 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
- Baylor Scott & White Health (Albany, NY)
- …of staff, resource management , and budget control. Departments involved are Utilization Management , Case Management , and Disease Management . ... Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- 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 (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 (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
- Dartmouth Health (Bennington, VT)
- …matriculated into a BSN program may be considered. * Prior experience in utilization review, discharge planning and/or case management preferred. * 3-5years of ... The Health Resource Manager is responsible for providing case management services for SVMC sub acute patients. $5,000.00 sign on retention bonus for qualified… more
- 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
- Humana (Albany, NY)
- …part of our caring community and help us put health first** The Compliance Nurse Auditor reviews utilization management activities and documentation to ... to prevent and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality Assurance Audit...care, skilled and/or rehabilitation clinical setting + Experience with utilization management , pre-service denials and/or quality assurance… more
- 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 (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
- 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
- Dartmouth Health (Bennington, VT)
- …matriculated into a BSN program may be considered.Prior experience in utilization review, discharge planning and/or case management preferred.3-5years of ... required. VT Nursing License required by date of employment. Case Management Certification required within 2 years ofemployment * Area of Interest:Nursing;… more
- 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
- 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
- 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
- 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
- Elevance Health (Latham, NY)
- …providers, claims, or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires ... ** Nurse Case Manager I - NICU** **Location:** **This...a timely fashion. + Knowledge of health insurance/benefits, medical management process, care management , and utilization… more
- Humana (Albany, NY)
- …your skills to make an impact** **Required Qualifications** + Associate degree + Active Registered Nurse , ( RN ), License in your state of residence without ... management and/or process improvement experience + Minimum 3 years utilization management experience with exposure to grievance and appeals + Proficient in… more