- Trinity Health (Schenectady, NY)
- …clinical assessment **What you will need:** **Must have Active Licensure as a Registered Nurse , Occupational Therapist, or Physical Therapist** **A minimum of 2 ... members, referral sources, and external payers regarding the effective and efficient utilization of program services and available resources. + Screening of clients… more
- MVP Health Care (Schenectady, NY)
- …in New York** **Qualifications you'll bring:** + Current New York State Licensure as a Registered Nurse required with at least 4 years of recent clinical and ... to confidentiality. + Ability to make independent decisions regarding resource utilization , and quality of care. + Must demonstrate understanding of clinical… more
- Mount Sinai Health System (New York, NY)
- …Practitioner in New York State + Current license and registration as a Professional Registered Nurse in NY State (NP candidates) + National Board Certification ... **Job Description** **Job Title - Advanced Practitioner Provider Manager ( Nurse Practitioner/Physician Assistant) - Ambulatory Oncology - Mount Sinai Hospital-Full… more
- CUNY (Brooklyn, NY)
- …for four years experience. **OTHER QUALIFICATIONS** - Current license to practice as a registered nurse in New York State. - Associates Degree in Nursing; ... in mastering technical skills. - Maintaining records of student utilization of practice labs and communicating with faculty regarding...information. **CLOSING DATE** RE-OPENED - Open Until Filled with Review of Resumes to Begin on April 21, 2025… more
- Evolent (Albany, NY)
- …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- CVS Health (Albany, NY)
- …visit, inpatient, skilled nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN , the TOC Coach ensures the member experiences a ... or changes in condition to be transitioned back to RN . + Complete post discharge call and required assessments...who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current… more
- Elevance Health (New York, NY)
- …and outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses appropriate screening ... equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC LPC LBA (as allowed by...is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with… more
- Mount Sinai Health System (New York, NY)
- …shift changes for job codes under the department of nursing such as Nurse Leaders, Educators, Registered Professional Nurses, Patient Care Associates, Nursing ... the Nursing Department. The Staffing Office collaborates with Nursing Leadership to review and develop schedules based on agreed upon staffing guidelines, models and… more
- Sharecare (Albany, NY)
- …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... orientation and to take the pre and post-test to review competency during orientation. Yearly competency test is required...will follow company policy to transfer call to an RN or appropriate colleague when member needs are outside… more
- St John's Community Services (Ithaca, NY)
- …11-bed residential facility. Activities include clinical supervision, plan development, review of client records/notes, program planning and group facilitation. Your ... + Ensures the development and maintenance of treatment plans. + Performs review and supervisory maintenance of official records including treatment plans, progress… more