- CDPHP (Albany, NY)
- …researching new and emerging technologies and interfacing with the medical directors, utilization review staff, and other key policy stakeholders Qualifications: ... will collaborate with the CDPHP team in the development, review and revision of CDPHP Resource Coordination policies, including...four (4) years of equivalent experience required. + Registered Nurse or Nurse Practitioner with valid NYS… more
- Mount Sinai Health System (Long Island City, NY)
- …Description** The Director will direct and manage departmental activities involved in utilization review , appeals management and discharge planning to facilitate ... years of Case Management and 6 years of clinical nurse experience. Previous supervisory experience in Case Management or...services by focusing on patient processes. 8.Develops and implements Utilization Review (UR) based on internal data… more
- Guthrie (Corning, NY)
- …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 BSN or BA degree ... two (2) years of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who holds a bachelor's degree in a related… more
- Catholic Health Services (West Islip, NY)
- …with Hospital Conditions of Participation. Implements care management programs, including utilization review , intake and discharge planning. Evaluates patient ... collaboratively with, but not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals, Managed Care and Revenue Cycle and Patient… more
- Humana (Albany, NY)
- …and leadership during Medicare and Medicaid LOB - Medicare Clinical Criteria Review (MCCR), Utilization Management Committee (UMC), Medical Coverage Policy ... maintain medical coverage policies utilizing an evidence based medicine review process. **Location:** work at home anywhere Humana is...any field or equivalent experience + Active unrestricted Registered Nurse (RN) license + 5 years or more of… more
- STG International (Watertown, NY)
- …safety. + Participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... Participate in the orientation of clinical staff physicians, physician assistants and nurse practitioners. + Provide leadership to CBOC clinicians. + Evaluate the… more
- STG International (Kingston, NY)
- …safety. + Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... Participate in the orientation of clinical staff physicians, physician assistants and nurse practitioners. + Provide leadership to CBOC clinicians. + Evaluate the… more
- STG International (Dunkirk, NY)
- …patient safety. *Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health ... in the orientation of clinical staff physicians, physician assistants and nurse practitioners. *Provide leadership to CBOC clinicians. *Evaluate the effectiveness of… more
- STG International (Auburn, NY)
- …safety. * Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... Participate in the orientation of clinical staff physicians, physician assistants and nurse practitioners. * Provide leadership to CBOC clinicians. * Evaluate the… more
- Albany Medical Center (Albany, NY)
- …of America) Salary Range: $60,028.00 - $99,023.00 Salary range: $33/hr. - $47.60/hr. Registered Nurse (RN) - Full TimeHIV Medicine Clinic - Albany, NY We have an ... advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN),...in EHR* Performs venipuncture per order of MD/APP* Performs review and triage of incoming test results, patient requests… more