- Rochester Regional Health (Rochester, NY)
- …class as needed. Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act as a resource on ... Job Title: Registered Nurse I Department: Utilization Management...with minimum direction. + Act as a resource for utilization review stakeholders and assists team members… more
- Cognizant (Albany, NY)
- …background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Evolent (Albany, NY)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- Catholic Health (Kenmore, NY)
- …and families in the hospital setting. Utilizing foundational nursing clinical skills Utilization Review nurse collaborates with the interdisciplinary team ... Rotation Hours: 8 am- 4 pm Summary: The Registered Nurse (RN), Utilization Review , as...in an Acute Care Hospital Setting + Proficiency in utilization management and regulatory requirements preferred +… more
- Albany Medical Center (Albany, NY)
- …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG criteria to monitor appropriateness of admissions… more
- Elevance Health (Latham, NY)
- …Finder and follows up with provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer ; and handles referrals for specialty ... ** Utilization Management Representative II** **Virtual:** This...+ Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title - Nurse Practitioner- Inpatient Oncology - Mount Sinai Hospital - Full Time - Day** A nurse practitioner (NP) as described in ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Mount Sinai Health System (New York, NY)
- **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Albany Medical Center (Albany, NY)
- …+ Basic knowledge of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or Compact ... works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to… more
- Veterans Affairs, Veterans Health Administration (Batavia, NY)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities The Batavia VA Medical Center is seeking a qualified full-time Registered Nurse (RN) to join Long-term care in the Community Living Center (CLC) in… more