• Delegation Oversight Nurse Remote…

    Molina Healthcare (Albany, NY)
    …Practical Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse ( RN ) Program or a bachelor's degree in Nursing. ... Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable state… more
    Molina Healthcare (04/20/25)
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  • Registered Dietitian - Remote

    Sharecare (Albany, NY)
    …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... orientation and to take the pre and post-test to review competency during orientation. Yearly competency test is required...will follow company policy to transfer call to an RN or appropriate colleague when member needs are outside… more
    Sharecare (05/03/25)
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  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    …Auth/Denial Management meetings EDUCATION: RN required. EXPERIENCE: NYS licensed Registered Nurse required. Bachelor's in nursing preferred. Must have ... Job Description Remote work available! Up to $10,000 Sign on...proficient writing skills.Experience in Utilization Review and InterQual required. CARDIOPULMONARY RESUSCITATION… more
    Arnot Health (02/06/25)
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  • Quality Assurance Senior Coordinator--UR

    SUNY Upstate Medical University (Syracuse, NY)
    Job Summary: The Utilization Review /Quality Assurance Sr. Coordinator will be responsible for providing clinical information to managed care companies as ... field) and a minimum of three years RN post-licensure nursing experience or RN Utilization Management, or Associate's Degree in Nursing and five years RN… more
    SUNY Upstate Medical University (03/10/25)
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  • Consultant, Nurse Disability

    Lincoln Financial (Albany, NY)
    …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at home employee residing outside...Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like… more
    Lincoln Financial (04/30/25)
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  • Transition of Care Associate - Licensed Practical…

    CVS Health (Albany, NY)
    …visit, inpatient, skilled nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN , the TOC Coach ensures the member experiences a ... or changes in condition to be transitioned back to RN . + Complete post discharge call and required assessments...who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current… more
    CVS Health (05/03/25)
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  • Behavioral Health Care Manager II

    Elevance Health (Latham, NY)
    …the delivery of care._ **Behavioral Health Care Manager II** **Location:** This is a remote , work from home position. The ideal candidate will live within 50 miles ... outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses...equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC LPC LBA (as allowed by… more
    Elevance Health (04/17/25)
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