- MVP Health Care (Schenectady, NY)
- …every interaction **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes ... **Qualifications you'll bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months… more
- Arnot Health (Elmira, NY)
- … of patient care . The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case Manager's average caseload ... The Case Manager tracks and trends LOS , resource utilization , outliers, readmissions , denials , delay days...nursing program with a current license as a registered nurse . BSN or Case Management Certification… more
- Datavant (Albany, NY)
- …function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in… more
- Albany Medical Center (Albany, NY)
- …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, NY We have an ... comprehensive HIV services including primary medical care, medical case management , medication adherence, peer services, substance abuse counseling, mental health… more
- Sharecare (Albany, NY)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Mount Sinai Health System (New York, NY)
- …as a liaison to nursing, medicine, department chairs/chiefs, care management , administration, and other department leadership. Ensures advanced practice nurses ... clinical advanced practice nursing. + Previous Nursing leadership and management experience preferred. + Possesses excellent communication and interpersonal skills.… more
- Calvary Hospital (Bronx, NY)
- …unencumbered NYS licensure. + Five (5) or more years experience in either Utilization Management , Quality Assessment and Improvement, Risk Management , and/or ... Spending, Transit Check. + Free On-Site Parking Requirements Participates in the Utilization Review, Discharge Planning, Risk Management , and Quality Assessment… more
- Stony Brook University (Stony Brook, NY)
- …our high standard of excellence. **Duties of a RN Case Manager in the Care Management Department may include the following but are not limited to:** + Completes ... Utilization review screen for inpatient and observation cases. Activity...assigned. Identifies, follows and documents Avoidable delays in Care Management Program. Reviews and documents on patients who were… more
- ZOLL Medical Corporation (New York, NY)
- …patients suffering from serious cardiopulmonary and respiratory conditions.ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed ... patients at risk of sudden cardiac death. + HFMS (https://cardiacdiagnostics.zoll.com/products/heart-failure-arrhythmia- management -system/) (Heart Failure Management system) is a… more
- Grifols Shared Services North America, Inc (Albany, NY)
- …institutions aligned with customer segmentation and enhance formulary and dosing protocols. * Utilization of Managed Markets, Marketing, Ig Nurse Educators, MSL, ... Centers ie neurology department with residents and fellows, Infusion Suite Nurse , Clinical Pharmacists, DOP for formulary consideration and specialty pharmacy etc.)… more