- Crouse Hospital (Syracuse, NY)
- …education and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage data and ... to the utilization of services. Pay Range: $80,000.00 / year + Utilization Management RNs are eligible for up to a $10,000 Sign-On Bonus! Schedule: Full… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Manager, Utilization Management Nursing (LTSS Utilization Management Leader) utilizes ... communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines and… more
- Molina Healthcare (Syracuse, NY)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The **Senior Analyst, Utilization Management ** plays a critical role in supporting clinical and ... business needs into technical solutions. This role works closely with clinicians, utilization management teams, and business stakeholders to gather requirements… more
- CVS Health (Albany, NY)
- …Must have active current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include ... in previous roles. **Preferred Qualifications** Managed Care experience and/or Utilization Management experience preferred **Education** Associates Degree in… more
- Trinity Health (Albany, NY)
- …these differences often lead to innovative solutions. **Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme Days** If ... to accommodate all schedules **What you will do:** + Perform utilization management , both concurrent and retroactive for inpatient and outpatient services in… more
- Humana (Albany, NY)
- …part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Elevance Health (Latham, NY)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for managing incoming calls,… more
- Molina Healthcare (Buffalo, NY)
- …state board licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/behavioral health settings. + One year of ... or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in Health Care… more
- Humana (Albany, NY)
- …into concrete roadmaps that will generate tangible value to all stakeholders. Within Utilization Management , our goal is to enable members to receive the ... math or business related + Minimum 2 years of experience with a leading management consulting firm + Strong analytical & strategic skillset + Ability to interpret… more
- Guthrie (Binghamton, NY)
- …necessary. Oversees and coordinates compliance to federally mandated and third party payer utilization management rules and regulations The pay range for this ... Provides health care services regarding admissions, case management , discharge planning and utilization review. Responsibilites: Reviews admissions and service… more
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