- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Crouse Hospital (Syracuse, NY)
- …health education and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage ... Bonus! Schedule: Full Time: 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse (RN) Position Responsibilities: + Works… more
- Trinity Health (Albany, NY)
- …differences often lead to innovative solutions. **Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme Days** ... to accommodate all schedules **What you will do:** + Perform utilization management , both concurrent and retroactive for inpatient and outpatient services in… more
- Trinity Health (Albany, NY)
- …in Albany, NY** is looking for an experienced RN to work as a Registered Professional Utilization Management Nurse (UMRN) per diem. The team is willing to ... Type:** Part time **Shift:** Day Shift **Description:** **RN for Utilization Management - Per Diem** **St. Peter's...selected candidate will** : + Be responsible for the utilization management , both concurrent and retroactive for… more
- Cognizant (Albany, NY)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Lincoln Financial (Albany, NY)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Bassett Healthcare (Cooperstown, NY)
- …least 5 years of experience in Case Management , discharge planning, and/or Utilization Management Licensure/Certifications: + Registered Nurse or LMSW or ... the department. Oversees and works with the Director of Utilization Management to support and implement the...well as state and federal regulations.* Collaboration: Partner with nurse managers, nursing directors, and other leaders across the… more
- CDPHP (Latham, NY)
- …required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge of coding/claims processing is ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...transportation, DME requests and inpatient readmissions. In collaboration with management , the UR nurse identifies potentially high-cost… more
- Centene Corporation (New York, NY)
- …and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a ... million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization...as a State Issued NY ID.** **Position Purpose:** The Utilization Review Nurse I provides first level… more
- Albany Medical Center (Albany, NY)
- …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG criteria to monitor appropriateness of admissions… more