- Independent Health (Buffalo, NY)
- …perks, benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Utilization Review Nurse (URN) performs clinical review ... required; Bachelor's degree preferred. Current, active, unrestricted, and licensed registered nurse ( RN ) required. +... in a varied clinical setting required. + Previous utilization review experience preferred. + Previous experience… more
- Mohawk Valley Health System (Utica, NY)
- …Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member care needs ... RN Supervisor Case Management - Full...Performs related duties as assigned. Education/Experience Requirements REQUIRED: + Registered Nurse licensed in State of New… more
- Northwell Health (Forest Hills, NY)
- … Case Management, preferred.Minimum five (5) years clinical experience as a registered nurse . Prior experience in utilization management and/or discharge ... Degree, preferred.Current license to practice as a Registered Professional Nurse in New York State.Patient Review Instruments (PRI) Certification, preferred.… more
- Stony Brook University (Stony Brook, NY)
- RN Case Manager **Position Summary** At...the following but are not limited to:** + Completes Utilization review screen for inpatient and observation ... Stony Brook Medicine, a ** RN Case Manager** is a valuable member...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN… more
- Northwell Health (Staten Island, NY)
- …Nursing, required. + Current license to practice as a Registered Professional Nurse in New York State. + Case Management Certification, preferred. + Minimum ... management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. + Keeps… more
- Molina Healthcare (Buffalo, NY)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...clinical nursing experience, including at least 1 year of utilization review , medical claims review ,… more
- CenterWell (Westbury, NY)
- …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Albany Medical Center (Albany, NY)
- …States of America) Salary Range: $83,200.00 - $128,960.00 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 (Buffalo, NY)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...the specific programs supported by the plan such as utilization review , medical claims review ,… more
- Albany Medical Center (Albany, NY)
- …of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... clinical experience in an assigned service - required + Recent experience in case management, utilization management and/or discharge planning/home care in a… more