- Guthrie (Corning, NY)
- …demonstrates leadership and autonomy in nursing practice. Preferred experience with care management / utilization review , and payer knowledge. Fast paced ... assessment and support for treatment regimen adherence and medication management , education to patient and/or family members to support...applicant must have a current license as a Professional Registered Nurse in their state of practice… more
- Mount Sinai Health System (Long Island City, NY)
- **Job Description** The Director will direct and manage departmental activities involved in utilization review , appeals management and discharge planning to ... field. **Licensing and Certification Requirements (if applicable)** Licensed as a registered nurse , Issuing Agency: Department of Health/Office of Professions… more
- CDPHP (Albany, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge of… more
- Albany Medical Center (Albany, NY)
- …in the field of Clinical Social Work or Nursing with experience in Case Management , Utilization Review and Discharge Planning. * BLS Certification. * ... principles of conflict resolution and promote consensus building.* Represents Case Management /Social Work at organizational committee meetings as directed* Serves as… more
- Catholic Health Services (West Islip, NY)
- …Staff. Ensures compliance with Hospital Conditions of Participation. Implements care management programs, including utilization review , intake and ... management leadership role is required. Experience in utilization management , working with managed care organizations,...Master of Science degree strongly preferred. Licensure: New York Registered Nurse ( RN ) License &… more
- Nuvance Health (Poughkeepsie, NY)
- …BSN preferred. Must have current RN license. Preferred experience in Utilization Review / Management .Company: Vassar Brothers Medical Center Org Unit: 1190 ... case from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within… more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them...beneficiary and the Network Provider. + Provides first level RN review for all outpatient and ancillary… more
- CenterLight Health System (Ridgewood, NY)
- …experience in care/case management , disease management , population health management , utilization review , quality assurance, or discharge planning ... systems License: Current active and unrestricted license in NYS as a Registered Nurse , required. Additional Requirements: + Be legally authorized (for example,… more
- FlexStaff (New York, NY)
- …experience in care/case management , disease management , population health management , utilization review , quality assurance, or discharge planning ... systems License: Current active and unrestricted license in NYS as a Registered Nurse , required. Additional Requirements: Be legally authorized (for example,… more
- Centene Corporation (New York, NY)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more