- CenterWell (Albany, NY)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- CenterWell (Albany, NY)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
- Mohawk Valley Health System (Utica, NY)
- …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... RN Supervisor Case Management - Full...Performs related duties as assigned. Education/Experience Requirements REQUIRED: + Registered Nurse licensed in State of New… more
- Villa of Hope (Rochester, NY)
- …JOB SUMMARY: Under the general direction of the Nurse Manager, the Intake Coordinator- RN is a Registered Nurse who will assist in supervising Clinical ... director of LHTC and administrative team, including billing and utilization review . + Triages potential admissions and...or leaving against medical advice. MINIMUM QUALIFICATIONS: + NYS Registered Nurse license + Bachelor degree preferred… more
- Guthrie (Corning, NY)
- …or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or ... of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who...understanding of the regulatory requirements relative to the case management process. Certified to complete Patient Review … more
- Catholic Health Services (Melville, NY)
- …queries from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, ... care to MCC in response to physician order, or review of updated clinical information Acts as a resource...current with industry standards and business objectives related to Utilization and Care Management as appropriate. Sound… more
- CenterWell (Hauppauge, NY)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home health ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...(NY state requirement) + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Molina Healthcare (Yonkers, NY)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years… more
- Albany Medical Center (Albany, NY)
- …States of America) Salary Range: $60,028.00 - $99,023.00 Salary range: $33/hr. - $47.60/hr. Registered Nurse ( RN ) - Full TimeHIV Medicine Clinic - Albany, ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...Nursing program is required* Current NYS license as a Registered Nurse is required* Minimum of 1-2… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… more