- 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
- CVS Health (Albany, NY)
- …Qualifications** + Must reside in EST zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required + Must have active ... current and unrestricted RN licensure in state of residence + 1+ year(s)...able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work… more
- University of Rochester (Rochester, NY)
- …qualifications, expertise of the individual, and internal equity considerations._ **Responsibilities:** The Utilization Management (UM) RN position spans the ... Type: Full time Scheduled Weekly Hours: 40 Department: 500009 Utilization Management Work Shift: Range: UR URCB...is remote with some on-site requirements as needed. Qualifications: RN with Utilization Review experience preferred; 3-5… 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
- CDPHP (Albany, 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
- Catholic Health Services (Melville, NY)
- …queries from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, ... accredited Nursing School or College; current New York State, RN License required, BSN Bachelor of Science in Nursing...current with industry standards and business objectives related to Utilization and Care Management as appropriate. Sound… more
- Northwell Health (New York, NY)
- …or throughout the entire continuum of health care delivery. Performs resource management , utilization management , discharge planning, care facilitation, ... defined patient population, and as it relates to care management and the delivery of patient care services. Communicates...Degree, preferred. + Current license to practice as a Registered Professional Nurse in New York State.… more
- Crouse Hospital (Syracuse, NY)
- …management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... Manager who is responsible for providing day to day management of the RN Care Managers in...agreements. Manager, Care Coordination Requirements: + Licensed as a Registered Nurse in New York State +… more
- Catholic Health Services (Port Jefferson, NY)
- … 3+ Years acute care clinical RN experience required Prior RN experience in Utilization Management , Performance Improvement, Transition Planning ... across the acute care continuum. Perform required activities for utilization management , PRI assessment and completion, transition...in a BSN program may apply Licensure: New York Registered Nurse ( RN ) License &… more
- Stony Brook University (Stony Brook, NY)
- …including managing Case Management leadership and staff functions related to case management and utilization management activities. + Manage and mentor a ... design, development, implementation, and monitoring of the organization's case management and utilization review functions. + Lead...degree. * Possession of license to practice as a registered nurse in New York State *… more