- 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
- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review /Medical and Case Management services for Group Health and Workers' ... services for timely return to work. + Provides case management , utilization review , continued stay...MagnaCare policies and procedures. Essential Qualifications + Currently licensed Registered Nurse in the state of NY,… more
- Loretto Management Corporation (Syracuse, NY)
- …a confidential organized manner. + Works in collaboration with the Director of Utilization Management /Information Systems for review of hospitalizations with ... CNY is currently hiring for a Home Care Coordinator RN ! The Home Care Coordinator RN assists...role during an event. Qualifications + Currently licensed as Registered Nurse in New York State. +… more
- Centene Corporation (New York, NY)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- Albany Medical Center (Albany, NY)
- …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG...with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State… 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
- CVS Health (Albany, NY)
- …is a fully remote position. The requirements is for candidates to hold a **New York Registered Nurse ** License. This employee will work four - 10 hour days per ... week. This role is a registered nurse that utilizes MCG rules and...unrestricted New York state licensure + 1+ year of Utilization review experience + 1+ year of… 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
- CenterLight Health System (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