- CenterWell (Albany, NY)
- …and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain… more
- Molina Healthcare (Yonkers, NY)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Stony Brook University (Stony Brook, NY)
- RN Case Manager **Position Summary** At...the following but are not limited to:** + Completes Utilization review screen for inpatient and observation ... Stony Brook Medicine, a **TH Staff Associate/Case Manager ** is a valuable member of our team, who...other duties as required. **Qualifications** **Required** : Current NYS RN . A Bachelor's degree or a nurse … more
- Albany Medical Center (Albany, NY)
- …States of America) Salary Range: $60,028.00 - $99,023.00 Salary range: $33/hr. - $47.60/hr. Registered Nurse ( RN ) - Full TimeHIV Medicine Clinic - Albany, ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or ...Nursing program is required* Current NYS license as a Registered Nurse is required* Minimum of 1-2… more
- Arnot Health (Elmira, NY)
- …related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case ... of self and other case managers. f. The Case Manager tracks and trends LOS, resource utilization ,... nursing program with a current license as a registered nurse . BSN or Case Management Certification… more
- Bassett Healthcare (Cooperstown, NY)
- …optimum health and enjoy the best quality of life possible. What you'll do The STAT Nurse RN will provide clinical support and direct patient care in a variety ... of inpatient units during peak periods of activity. The STAT Nurse RN will provide episodic nursing care, assist with patient flow, respond to Rapid Response,… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support,… more
- Albany Medical Center (Albany, NY)
- …Work Shift: Day (United States of America) Salary Range: $60,028.00 - $99,023.00 Registered Nurse ( RN ) - Full Time Pediatric Endocrine Department ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or ...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
- Northwell Health (Staten Island, NY)
- …case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. + Keeps ... utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of...Nursing, required. + Current license to practice as a Registered Professional Nurse in New York State.… more
- Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
- …Assurance) as required, and as directed by their supervisor and Administrator MDS Director RN Qualifications: + Registered Nurse with current, active license ... MDS Director RN Glengariff Rehabilitation and Healthcare Center is looking...basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves… more