- CVS Health (Albany, NY)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... in **Specialty Pharmacy or Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Rochester Regional Health (Rochester, NY)
- …efficient utilization of resources. Carries out activities related to utilization management , discharge planning, care coordination and referral to other ... in daily Huddles, providing ongoing communication to the Charge Nurse and Nurse Manager to address complex...hospital care experience not required. PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience… more
- Ellis Medicine (Schenectady, NY)
- …Services discharge planning guidelines and departmental/organizational policies and processes + Utilization Management : + Ensures order in chart/EMR coincides ... the Case Manager include, but are not limited to, utilization review, case management , care transition, collaboration...+ Current license or valid permit to practice professional nursing in the state of New York + Associate's… more
- Catholic Health Services (Port Jefferson, NY)
- …for patients across the acute care continuum. Perform required activities for utilization management , PRI assessment and completion, transition planning, and ... Years acute care clinical RN experience required Prior RN experience in Utilization Management , Performance Improvement, Transition Planning and/or Care … more
- Guthrie (Binghamton, NY)
- … (BSN) or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing . A registered nurse with five (5) years relevant experience willing to pursue a ... hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who holds a bachelor's...experience in an acute care setting with strong care management , utilization review, and payer knowledge. A… more
- Trinity Health (Troy, NY)
- …Friday - Samaritan HospitalIf you are looking for a position in RN (Registered Nurse ) Case Management in a dynamic hospital, this could be your opportunity. ... **Description:** We at St. Peter's Health Partners recognize that nursing is one of the most challenging careers and...in acute settingPreferred requirements:1+ year of experience in case management or utilization managementCase Management … more
- Crouse Hospital (Syracuse, NY)
- …of hospital resources while maintaining the quality of care. + Participates in the utilization management process using standards of care to determine the most ... Nurse (RN) license. + Graduate from an accredited nursing degree program required. + Bachelor of Science degree...years acute hospital experience. + NICU experience + Case Management or Utilization Management experience… more
- CenterWell (Albany, NY)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a… more
- Catholic Health Services (West Islip, NY)
- …a hospital care management leadership role is required. Experience in utilization management , working with managed care organizations, and discharge planning ... : Works collaboratively with, but not limited to, Medical Staff, Quality/Risk Management , CH Utilization and Central Appeals, Managed Care and Revenue… more
- Molina Healthcare (Yonkers, NY)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical… more