- CenterWell (Albany, NY)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- CenterWell (Westbury, NY)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home health, ... **Branch Location** : Westbury, NY **This is not a remote or work-from-home position. This position requires you to...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Molina Healthcare (NY)
- For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (NY)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Buffalo, NY)
- …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** Looking for a RN that has a current active unrestricted license...appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports… more
- Sharecare (Albany, NY)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Mount Sinai Health System (New York, NY)
- …Active RN license in the state of employment required + Certification in Case Management (CCM, ACM) or Utilization Management preferred. + 7+ years of ... **Job Description** **Director Pre Appeals Management -HSO Appeals Management -Corporate 42nd Street-Full-Time-Days - Remote ** The Director,...experience in clinical acute clinical, utilization management , appeals management or… more
- Molina Healthcare (Rochester, NY)
- …transitions, behavioral health, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ), Licensed Vocational Nurse (LVN), ... external vendors. * Focuses on process improvement, organizational change management , program management and other processes relative...years in one or more of the following areas: utilization management , care management , care… more
- Highmark Health (Albany, NY)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more