• Utilization Management Nurse…

    CVS Health (Albany, NY)
    …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in ET zones **Education**… more
    CVS Health (09/10/25)
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  • Utilization Management Nurse…

    CVS Health (Albany, NY)
    …And we do it all with heart, each and every day. **Position Summary** Utilization Management operates 24/7, and work schedules will include evenings, weekends, ... Minimum of 2 years of experience as a Registered Nurse in an adult acute care or critical care...areas. + Prior experience in Managed Care, particularly in Utilization Management . + Preference given to candidates… more
    CVS Health (09/06/25)
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  • Clinical Audit and Appeals Consultant

    Intermountain Health (Albany, NY)
    …specialty care settings or previous appeals experience. + Demonstrated experience in utilization review and/or case management , hospital insurance billing, third ... **Job Description:** The RCO Audit & Appeals RN Consultant is responsible for consulting on clinical Appeals and Audits for Intermountain Health. The Audit/Appeals… more
    Intermountain Health (09/08/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …psychosocial needs and coordinate transition of care with Social Worker + Serves as nurse consultant for Social Worker cases with Clinical or discharge planning ... Services discharge planning guidelines and departmental/organizational policies and processes + Utilization Management : + Ensures order in chart/EMR coincides… more
    Ellis Medicine (09/11/25)
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