- 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
- Centene Corporation (New York, NY)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... New York State RN license.** **Inpatient Utilization Management ** **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or… more
- CDPHP (Latham, 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
- 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
- Nuvance Health (Poughkeepsie, NY)
- …BSN preferred. Must have current RN license. *Preferred Experience: * Utilization Review / Management .Company: Vassar Brothers Medical Center Org Unit: ... case from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within… more
- Elevance Health (Latham, NY)
- …health insurance/benefits, medical management process, care management , and utilization review management is strongly preferred. + Clinical ... **Telephonic NICU Nurse Case Manager I** **Location: This role enables...claims, or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- CVS Health (Albany, NY)
- …with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management opportunity for RNs with a **New York** state licensure. ... Friday, 8:30am - 5pm EST. 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
- Catholic Health Services (West Islip, NY)
- …+ Ensures compliance with Hospital Conditions of Participation. + Implements care management programs, including utilization review , intake and discharge ... management leadership role is required. + Experience in utilization management , working with managed care organizations,...of Science degree strongly preferred. + Licensure: New York Registered Nurse ( RN ) License &… more
- Molina Healthcare (Albany, 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 ... 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