- Molina Healthcare (Buffalo, NY)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal appeals clinical processes - ensuring that appeals requests are… more
- Molina Healthcare (Rochester, NY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Albany, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *...in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge… more
- Albany Medical Center (Albany, NY)
- …Work Shift: Per Diem (United States of America) Salary Range: $83,200.00 - $128,960.00 Registered Nurse ( RN ) - Per Diem Outpatient Pediatric Specialties 22 ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...Registered Nursing program is required + NYS current RN licensure to practice professional nursing is required +… more
- Albany Medical Center (Albany, NY)
- …Work Shift: Day (United States of America) Salary Range: $83,200.00 - $128,960.00 Registered Nurse - Full Time Women's Health Office Work schedule: Monday ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...Registered Nursing program is required + NYS current RN licensure to practice professional nursing is required +… more
- Molina Healthcare (Bronx, NY)
- …and/or managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... cost-effective member care. Essential Job Duties * Performs audits in utilization management, care management, member assessment, behavioral health, and/or other… more
- Catholic Health Services (West Islip, NY)
- …degree required. + Master of Science degree strongly preferred. + Licensure: New York Registered Nurse ( RN ) License & Registration. + Certification: Care ... collaboratively with, but not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals, Managed Care and Revenue Cycle and Patient… more
- Molina Healthcare (Rochester, NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical...member care. The candidate must have Medicare Appeals and/or Utilization Management knowledge. Work hours are Monday-Friday 8:00am- 5:00pm… more
- UHS (Norwich, NY)
- Position OverviewThe Registered Nurse ( RN ) or Graduate Nurse (GN) protects, promotes, and optimizes health and abilities, prevention of illness and ... advocacy in the care of individuals and families. The RN or GN is responsible and accountable for compliance...professional development in accordance with the New York State Nurse Practice Act, United Health Services policies, ANA Scope… more
- Molina Healthcare (NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** The Care Review Clinician ( RN ) provides support for clinical member services review...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** *… more