- 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 ... 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
- Glens Falls Hospital (Glens Falls, NY)
- …30 hours per week, can be found*here*. **Job:** **Nursing - Case Management* **Title:** * Registered Nurse ( RN ) - Care Manager (GFMG) (Flexible Scheduling ... condition that may necessitate treatment change and will attend regular case review meetings. The Care Manager will work closely with the Interdisciplinary Team… 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
- Ellis Medicine (Schenectady, NY)
- Basic Function: The Utilization Management Registered Nurse (UM RN ) supports daily coordination of care across healthcare continuum with the healthcare ... preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures...care related field required. Current registration as a Licensed Registered Professional Nurse in New York State.… more
- CVS Health (Albany, NY)
- …care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and ... opportunities to promote quality effectiveness of healthcare services and benefit utilization . **Required Qualifications** + Active and unrestricted RN licensure… more
- CVS Health (Albany, NY)
- …could be up to 10% in the event of a clinical audit. As a Utilization Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate ... with heart, each and every day. **Position Summary:** This Utilization Management Nurse Consultant (UMNC) position is...the past 10 years). **Preferred Qualifications:** -2 years of Utilization Review experience -2 years of Managed… more
- Humana (Albany, NY)
- …an impact** **Required Qualifications** **Must meet one of the following:** + Active unrestricted registered nurse license in the state of Virginia or obtain a ... problem-solving skills, facilitation skills **Preferred Qualifications** + Experience with utilization review process + Experience with behavioral change,… more
- Humana (Albany, NY)
- …**Required Qualifications:** **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of Virginia or reside ... case manager required. **Additional Information:** **Workstyle:** Remote work at Home **Location for Registered Nurse :** must reside in the state of Virginia or… 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
- 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
- Albany Medical Center (Albany, NY)
- …of America) Salary Range: $60,028.00 - $99,023.00 Salary range: $68,640 - $99,023 Registered Nurse - Full Time Neurosurgery Outpatient Office Work schedule: ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
- Albany Medical Center (Albany, NY)
- …Work Shift: Day (United States of America) Salary Range: $60,028.00 - $99,023.00 Registered Nurse - Full Time Pediatric Nephrology Department Work schedule: ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...wellness Minimum Qualifications:* Associate's degree of a state accredited Registered Nursing program is required* NYS current RN… 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...NY State requirements. + Current state license as a Registered Nurse . + Proof of current CPR.… 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
- Molina Healthcare (Albany, NY)
- …* UAS experience * Experience conducting home visits Required Licensure or Certification: * Registered Nurse ( RN ) State Specific Requirements: * Must reside ... for Medicaid and Medicare. We are looking for a RN candidate with a Uniform System Assessor (USA) background....and using durable medical equipment (DME). * Experience in utilization review , concurrent review and/or… 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 ... strategies for variance reduction. Qualifications and Ideal Characteristics 1. Registered nurse with a current license. 2....Basic knowledge of computer systems with skills applicable to utilization review process. Mission, Core Values and… more
- Albany Medical Center (Albany, NY)
- …of the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse Supervisor ( RN ), the ... overall health and wellness Minimum Qualifications* Associate's degree of a state accredited Registered Nursing program is required* NYS current RN licensure to… more
- Elevance Health (Latham, NY)
- …fraud and over- utilization by performing medical reviews via prepayment claims review and post payment auditing. + Correlates review findings with ... ** Nurse Audit Sr** **Location:** This position will work...responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through… 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 ... major office (PulsePoint) location listed above. The **Medical Management Nurse ** is responsible for review of the...an equivalent background. + Current active, valid and unrestricted RN license and/or certification to practice as a health… more