• 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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  • Utilizaiton Management Nurse

    CVS Health (Albany, NY)
    …Work schedules may 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
    CVS Health (01/03/25)
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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 (10/19/24)
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  • UM Nurse -Compact RN License…

    Humana (Albany, NY)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...an impact** **Required Qualifications** + Bachelor's degree + Licensed Registered Nurse ( RN ) in the… more
    Humana (01/03/25)
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  • Discharge Planner

    Ellis Medicine (Schenectady, NY)
    …is to work with the Social Worker, Nurse Case Manager, or Utilization Management Nurse to facilitate patient discharge plans, support coordination ... of care activities, and assist in utilization management activities under the direction of a registered... management activities under the direction of a registered nurse and/or social worker. Responsibilities include… more
    Ellis Medicine (11/28/24)
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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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  • UM Nurse Consultant (Remote)

    CVS Health (Albany, NY)
    …care more personal, convenient and affordable. This is a full-time telework role. Utilization Management is a 24/7 operation and work schedules may include ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + 3+ years of clinical...of clinical experience in acute or post-acute setting + Utilization Management is a 24/7 operation and… more
    CVS Health (01/03/25)
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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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  • Clinical Reviewer, Nurse - Cardiac

    Evolent (Albany, NY)
    …Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
    Evolent (01/03/25)
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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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  • 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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  • Nurse Case Manager ll

    Elevance Health (Latham, NY)
    …Health location. The ** Nurse Case Manager ll** is responsible for care management within the scope of licensure for members with complex and chronic care needs ... providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** Requires BA/BS… more
    Elevance Health (12/21/24)
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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 (11/24/24)
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  • Clinical RN Comp Care - Remote

    Sharecare (Albany, NY)
    …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...the disease management program intervention guidelines. An RN is supervised by an Operations Manager (OM). All… more
    Sharecare (12/17/24)
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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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