- Humana (Albany, NY)
- …**Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in Virginia or enhanced compact license, ... caring community and help us put health first** The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination,… 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
- CVS Health (Albany, NY)
- …skills, both verbal and written **Required Qualifications** + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required + Must have ... active current and unrestricted RN licensure in state of residence + Must possess...be able to work Mon-Fri 8:30am-5pm or 10:30am-7pm EST. Utilization Management is a 24/7 operation and… 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
- CDPHP (Albany, NY)
- …Minimum two (2) years of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York… more
- CVS Health (Albany, NY)
- …Work schedules will include weekends and holidays and evening rotations. As a Utilization Management Nurse Consultant, you will utilize clinical skills ... time zone + 3+ years of experience as a Registered Nurse + 1+ years of clinical... RN licensure in state of residence + Utilization management is a 24/7 operation. Work… more
- 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 ... of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community...level degree in Nursing may have opportunity to become registered as a nurse with a state… 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 Manager** **Full-Time Days** **St. Peter's Hospital**...Engage the patient and care team in the joint management of key patient outcomes such as management… more
- Elevance Health (Latham, NY)
- **Medical Management Nurse ** **Office Location** : Atlanta, GA; Indianapolis, IN; Latham, NY; Middletown, NY; New York, NY; Chicago, IL, St. Louis, MO; Durham, ... commute to the Elevance Health major office (PulsePoint) location listed above. The **Medical Management Nurse ** is responsible for review of the most complex or… 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 ... and develops strategies for variance reduction. Qualifications and Ideal Characteristics 1. Registered nurse with a current license. 2. Bachelor's degree… more
- Highmark Health (Albany, NY)
- …+ Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse ( RN ) license + Delaware RN ... Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health… 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
- 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
- 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
- Fresenius Medical Center (Albany, NY)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... quality of patient care, as defined by the quality goals, by working with management to ensure that policies and procedures are followed. + Assists with implementing… more
- 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
- MVP Health Care (Schenectady, NY)
- …you'll bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months after ... **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes assessment, planning,… more
- 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 (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
- Elevance Health (Latham, NY)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires ... ** Nurse Case Manager II** **Location:** This position will... Case Manager II** will be responsible for care management within the scope of licensure for members with… more