- Guthrie (Binghamton, NY)
- …services regarding admissions, case management , discharge planning and utilization review . Responsibilites: Reviews admissions and service requests within ... planning needs with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversees and coordinates compliance to… more
- Centene Corporation (New York, NY)
- …+ Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact State ... care, provider interactions, and facilitates operations within utilization management . + Manages prior authorization, concurrent review , and retrospective… more
- Crouse Hospital (Syracuse, NY)
- …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data ... (typically requires 6 weekends a year). Utilization Management Registered Nurse ( RN...the quality of care. + Demonstrates proficiency with standard Utilization Review processes. + Responsible for concurrent… more
- Veterans Affairs, Veterans Health Administration (Buffalo, NY)
- …Buffalo Location. The Nurse Utilization Management (UM) Registered Nurse ( RN ) executes position responsibilities that demonstrate leadership, ... Nurse Utilization Management (UM) Registered Nurse ( RN ) executes position...application of UM methods and expertise in medical necessity review criteria. This position requires strong analytical skills and… more
- Bassett Healthcare (Cooperstown, NY)
- …experience as a Registered Nurse , if experience is not relevant, Registered Nurse II must complete RN residency program, required License/ ... Certification: Current NYS license as a Registered Nurse , required BLS certification will be...terminate or be suspended at any time. Bonus Amount: RN (excluding management ) sign-on bonuses are awarded… more
- Guthrie (Binghamton, NY)
- …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant...members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria.… more
- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... authorization requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference… more
- Glens Falls Hospital (Glens Falls, NY)
- …per week, can be found*here*. **Job:** **Nursing - Case Management * **Title:** * Registered Nurse ( RN ) - Care Manager (GFMG) (Flexible Scheduling Options ... condition that may necessitate treatment change and will attend regular case review meetings. The Care Manager will work closely with the Interdisciplinary Team… more
- Molina Healthcare (Rochester, NY)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **WORK SCHEDULE: Mon - Fri / Sun… more
- Fresenius Medical Center (New York, NY)
- …and FMS risk management initiatives. + Collaborates with the Clinical Coordinator/Charge RN or Nurse Supervisor to ensure the aggressive treatment of, and ... + Collaborates closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse manager, the… more