• Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …services provided by the Case Manager include, but are not limited to, utilization review , case management , care transition, collaboration with ... years of inpatient experience in a hospital environment preferred. + Previous case management , utilization review , and discharge planning experience… more
    Ellis Medicine (07/25/25)
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  • Director of Case Management

    Stony Brook University (Stony Brook, NY)
    …the design, development, implementation, and monitoring of the organization's case management and utilization review functions. + Lead initiatives to ... Management leadership and staff functions related to case management and utilization ...and collaboration with Social Work Services * Knowledge of Utilization Review and Denial/Appeals * Knowledge of… more
    Stony Brook University (08/08/25)
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  • RN Utilization Review - System Care…

    Guthrie (Binghamton, NY)
    Provides health care services regarding admissions, case management , discharge planning and utilization review . Responsibilites: Reviews admissions and ... retrospective medical necessity and/or compliance with reimburesement policy criteria. Provides case management and/or consultation for complex cases. Assists… more
    Guthrie (07/05/25)
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  • Medical Director, Commercial Line of Business

    Excellus BlueCross BlueShield (Rochester, NY)
    …and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review activities include: reviews of requests ... I Qualifications) + Minimum 2-3 years of experience in medical management , utilization review and case management . + Knowledge of managed care… more
    Excellus BlueCross BlueShield (07/01/25)
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  • Insurance Specialist - Samaritan Hospital - PD…

    Trinity Health (Troy, NY)
    …completed a college level course in medical terminology. + One year of case management or utilization review /billing or coding experience. + One year of ... records/billing or healthcare related field + One year of case management or utilization review , billing, or coding experience Please be aware for the… more
    Trinity Health (07/26/25)
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  • RN-Education Spec-Clin Center for Learning…

    Albany Medical Center (Albany, NY)
    …* Experience in the field of Clinical Social Work or Nursing with experience in Case Management , Utilization Review and Discharge Planning. * BLS ... Demonstrate principles of conflict resolution and promote consensus building.* Represents Case Management /Social Work at organizational committee meetings as… more
    Albany Medical Center (06/03/25)
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  • Utilization Management

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing… more
    Mount Sinai Health System (07/12/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    review , and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our Inpatient, ... degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care… more
    Helio Health Inc. (08/08/25)
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  • Patient Management Supervisor

    Kaleida Health (Williamsville, NY)
    …Suite and Outlook. 2 years of experience In any combination of: case management , home care and utilization review preferred. Knowledge of and experience ... **Patient Management Supervisor** **Location:** Millard Fillmore Suburban **Location of...provides leadership to Patient Care Coordinators to support care management and interventions for patients and families. The supervisor… more
    Kaleida Health (08/02/25)
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  • Patient Care Coordinator

    Kaleida Health (Williamsville, NY)
    …Nursing Experience required. 2 years of experience in any combination of case management , home care and utilization review preferred. Knowledge of and ... members of the interdisciplinary team to coordinate care, facilitate utilization and resource management and discharge planning...outcomes for the patient in the acute care setting. Case management is a process that efficiently… more
    Kaleida Health (06/19/25)
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