• Appeals Manager

    BronxCare Health System (Bronx, NY)
    Overview The Appeals Manager is responsible to assist in the analysis and preparation of response to denial notification letters that arrive in letter and ... to best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials… more
    BronxCare Health System (11/15/25)
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  • Director Utilization Management

    Healthfirst (NY)
    …and improve department performance + Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement + Lead ... including but not limited to Care Management, Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to align utilization decisions + Partner… more
    Healthfirst (12/04/25)
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  • RN/Case Manager -MSH-Case…

    Mount Sinai Health System (New York, NY)
    …Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
    Mount Sinai Health System (01/13/26)
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  • RN/Case Manager (Inpatient)-Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5 years? experience as a ... **Job Description** **RN/Case Manager (Inpatient) Mount Sinai Morningside FT Days EOW**...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
    Mount Sinai Health System (01/15/26)
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  • Care Coordination Manager (Registered…

    Crouse Hospital (Syracuse, NY)
    …day management of the RN Care Managers in the department , including Utilization Management, Discharge Planning and Denials and Appeals functions. + Assessing ... Crouse's Care Coordination team is hiring a Care Coordination Manager who is responsible for providing day to day...day management of the RN Care Managers in the department . Pay Range: $95,000 plus based on education and… more
    Crouse Hospital (12/11/25)
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  • Ancillary Srvs Network Account Manager I

    Healthfirst (Enfield, NY)
    …Claims departments. Clearly communicate resolutions and progress to the Providers. + Assist Appeals and Grievances (A&G) department by acting as liaison between ... policies and procedures such as billing and authorization requirements, utilization of Healthfirst's Provider portal, claims submission, etc., via various… more
    Healthfirst (01/13/26)
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