- Stony Brook University (Stony Brook, NY)
- … Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...other duties as required. **Qualifications** **Required** : Current NYS RN . A Bachelor's degree or a nurse … more
- Molina Healthcare (Syracuse, NY)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
- Guardian Life (Albany, NY)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Centers Plan for Healthy Living (Queens, NY)
- …with the guidance and plans they need for healthy living. JOB SUMMARY: The Utilization Management nurse works within a multidisciplinary team to help ... their home to improve their quality of life. The Utilization Management nurse will assess...NYS RN license + Minimum 2 years utilization management experience + Strong written and… more
- Bassett Healthcare (Cooperstown, NY)
- …management experience, preferred License/Certifications: Current NYS Licensure as a Registered Professional Nurse , required Case management certification, ... a principle liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate bed… more
- Highmark Health (Albany, NY)
- …triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, ... Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or… more
- FlexStaff (White Plains, NY)
- …and arrange long-term care services (nursing homes, rehab, etc.). + Monitor care management effectiveness, utilization , and adjust plans as needed. + Ensure ... **Req Number** 158644 Care Delivery Manager RN White Plains, NY Schedule: M-F, 8:30am to...IDT to coordinate care based on participant needs. + Review UAS assessments for accuracy. + Investigate and address… more
- Bassett Healthcare (Cooperstown, NY)
- …care nursing experience, required Licensure/Certifications: Current NYS Licensure as a Registered Professional Nurse , required Physical Requirements: Light work: ... requiring a bariatric bed, special equipment, interpreter svc, etc.). Review previous patient history and updates CL with key...terminate or be suspended at any time. Bonus Amount: RN (excluding management ) sign-on bonuses are awarded… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- STG International (Auburn, NY)
- …in quality improvement, care management , risk management , peer review , utilization review , clinical outcomes, and health enhancement activates. ... Performance Improvement Team (QPIT) strategic initiatives. + Participate in review and improvement of clinical success in of areas...of the clinic's day-to-day activity, in conjunction with the Registered Nurse ( RN )/CBOC Manager and… more