• VNS Health (Bronx, NY)
    …in relation to VNS Health goals and objectives and improves hospice utilization for hospice eligible patients. Works under general supervision. * Provides advanced ... with collaborative practice agreement and within scope of practice of a nurse practitioner. * Documents patient care services in accordance with VNS Health… more
    job goal (12/07/25)
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  • Fresenius Medical Care (Batavia, NY)
    …Classification of Disease (ICD) coding. Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. ... Test. Preferred but not required: 3+ years supervisory or project/program management experience. Med/surg or ICU/CCU experience. PHYSICAL DEMANDS AND WORKING… more
    Joboru (12/07/25)
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  • Utilization Management Clinical…

    CVS Health (Albany, NY)
    …we do it all with heart, each and every day. **Position Summary** The ** Utilization Management Clinical Nurse Consultant** utilizes clinical skills to ... Arizona Time Zone. **Preferred Qualifications** : + Previous experience with utilization management . + Previous clinical experience in Emergency Department,… more
    CVS Health (12/06/25)
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  • Utilization Management Nurse

    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 ... surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST zones **Education**… more
    CVS Health (12/05/25)
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  • Utilization Management Nurse

    CenterWell (Albany, NY)
    …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
    CenterWell (11/22/25)
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  • RN Utilization Management

    Trinity Health (Troy, NY)
    …differences often lead to innovative solutions. **Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme Days** ... to accommodate all schedules **What you will do:** + Perform utilization management , both concurrent and retroactive for inpatient and outpatient services in… more
    Trinity Health (09/30/25)
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  • Insurance Specialist

    Trinity Health (Syracuse, NY)
    …requirements for Utilization Management and works collaboratively with Utilization Management /Concurrent Review Nurse , physicians, staff and other ... identification of possible concurrent denials, forwards information to the appropriate Utilization Management /Concurrent Review Nurse within identified… more
    Trinity Health (11/05/25)
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  • Utilization Review Nurse

    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...Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State current license.* Bachelor's… more
    Albany Medical Center (12/03/25)
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  • Utilization Review Nurse

    CDPHP (Latham, NY)
    …required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge of coding/claims processing is ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...transportation, DME requests and inpatient readmissions. In collaboration with management , the UR nurse identifies potentially high-cost… more
    CDPHP (09/23/25)
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  • Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a ... license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all… more
    Centene Corporation (12/05/25)
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