- Molina Healthcare (NY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Rochester, NY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- SUNY Upstate Medical University (Syracuse, NY)
- …including PC, Windows, Microsoft applications, Zoom/WebEx platforms, etc. Preferred Qualifications: Utilization management or utilization review experience, ... contracts with reimbursement entities. This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure patients… more
- Cognizant (Albany, NY)
- …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- New York State Civil Service (Malone, NY)
- NY HELP Yes Agency Corrections and Community Supervision, Department of Title Registered Nurse 3 - Utilization Temp/Hourly Occupational Category Health Care, ... Possession of a license and current registration as a registered professional nurse in New York State;...clinical nursing experience of which one year was in utilization review and/or discharge planning.Substitution: a bachelor's… more
- Bassett Healthcare (Cobleskill, NY)
- …Experience: + New graduate or less than one year of experience as a Registered Nurse , required License/ Certification: + NYS licensure as Registered ... best quality of life possible. What you'll do The Registered Professional Nurse I, Acute Care is...as measured by periodic random preceptor and supervisory chart review as per probationary appraisal schedule. + ( RN… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member… more
- Whitney Young Health Center (Albany, NY)
- Registered Nurse ( RN ) Care Manager (Req 100984) Albany, NY (http://maps.google.com/maps?q=920+Lark+Drive+Albany+NY+USA+12207) Apply Description Be a part of ... principles of Patient Centered Medical Home (PCMH), the Care Manager ( RN ) will demonstrate professional nursing practice, excellent communication and critical… more
- New York State Civil Service (Bronx, NY)
- NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York City Children's Center - Bronx Campus, P27076 Occupational ... New York City Children's Center - Bronx Campus is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and efficiency… more
- Bassett Healthcare (Cooperstown, NY)
- …needs. The RN contributes to the support of patients through interdisciplinary teamwork. + Registered Nurse I: The RN I status is only appropriate for a ... hire. + Salary Range: $39.01- $58.51 per hour + Registered Nurse II: The RN ...as measured by periodic random preceptor and supervisory chart review as per probationary appraisal schedule + ( RN… more
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