- 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
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time) Schedule: ... Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
- Cognizant (Albany, NY)
- …have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Catholic Health (Kenmore, NY)
- …Days with Weekend and Holiday Rotation Hours: 8 am- 4 pm Summary: The Registered Nurse ( RN ), Utilization Review , as an active member of the Middle ... in the hospital setting. Utilizing foundational nursing clinical skills Utilization Review nurse collaborates with...facilitate movement of the patient through the continuum. The Utilization Review RN identifies 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
- Northwell Health (Staten Island, NY)
- …care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness ... license to practice as a Registered Professional Nurse in New York State. + Case Management... and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge… more
- Guthrie (Binghamton, NY)
- …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care...degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant… more
- Crouse Hospital (Syracuse, NY)
- …management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... agreements. Care Coordination Manager Requirements: + Licensed as a Registered Nurse in New York State +...acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical,… more
- Crouse Hospital (Syracuse, NY)
- …of care. Care Manager Position Requirements: + Must have a current New York State Registered Nurse ( RN ) license. + Graduate from an accredited nursing degree ... Coordination Services team is hiring a Care Manager to review the services delivered to patients and compare it...maintaining the quality of care. + Participates in the utilization management process using standards of care… more
- Catholic Health (Buffalo, NY)
- …Care Hospital Setting + Minimum five (5) years of experience working within Utilization Review /Case Management /Clinical Documentation Integrity or + Minimum ... interdisciplinary care team and works in conjunction with the Utilization Review Manager and Manager Clinical Documentation...EDUCATION + Bachelor of Science Nursing (BSN) degree + Registered Nurse with a current New York… more