- Crouse Hospital (Syracuse, NY)
- …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data ... Full Time: 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse ( RN ) Position Responsibilities: + Works collaboratively… more
- Humana (Albany, NY)
- …areas. **Use your skills to make an impact** **Required Qualifications** + An active, unrestricted Registered Nurse ( RN ) license in the state of Michigan. + ... of our caring community and help us put health first** The Manager, Utilization Management Nursing (LTSS Utilization Management Leader) utilizes clinical… more
- CVS Health (Albany, NY)
- …active current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include weekends, ... + **MUST LIVE IN EASTERN STANDARD TIME ZONE** + 4-5 years of experience as a Registered Nurse in adult acute care, critical care , emergency or med/surg setting… more
- Trinity Health (Albany, NY)
- …often lead to innovative solutions. ** Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme Days** If ... you are looking for an RN position in Case Management and a...accommodate all schedules **What you will do:** + Perform utilization management , both concurrent and retroactive for… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… 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
- 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
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Independent Health (Buffalo, NY)
- …Degree in Nursing required; Bachelor's degree preferred. Current, active, unrestricted, and licensed registered nurse ( RN ) required. + Two (2) years of ... Collaborative and Accountable. **Essential Accountabilities** Provide High Quality, Professional Utilization Management Services: (Medical necessity review for… more
- CDPHP (Latham, NY)
- …Minimum two (2) years of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York… more
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