• Utilization Management RN

    Ellis Medicine (Schenectady, NY)
    Basic Function: The Utilization Management Registered Nurse (UM RN) supports daily coordination of care across healthcare continuum with the healthcare team, ... preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures...State. Two (2) to three (3) years' experience in case management , discharge planning and/or progression of… more
    Ellis Medicine (04/03/25)
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  • Behavioral Health Care Manager I…

    Elevance Health (Middletown, NY)
    …staff supervision. **Preferred Skills, Capabilities and Experiences:** + Previous experience in case management / utilization management with a broad ... to improve the delivery of care. **Title** : Behavioral Health Care Manager- Utilization Management **Location:** **Virtual** : This role enables associates to… more
    Elevance Health (05/28/25)
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  • Physician Advisor

    WMCHealth (Valhalla, NY)
    …of Integrated Case Management including mentoring/coaching care coordinators, utilization review staff and social workers. + Reviews cases for medical ... and/or appeals agency preferred. Previous utilization management , case management or peer review documentation experience in hospitals or health… more
    WMCHealth (05/22/25)
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  • RN/ Case Manager-MSH- Case

    Mount Sinai Health System (New York, NY)
    …limited to: a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using ... **Job Description** **RN/ Case Manager MSH Case Management...in homecare, long term care or utilization review preferred. + Discharge Planner or Case more
    Mount Sinai Health System (04/15/25)
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  • Case Manager, RN- Case

    Northwell Health (Staten Island, NY)
    …care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness ... of patient care outcomes. + Submits data to management regarding case management and/or... and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge… more
    Northwell Health (05/29/25)
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  • Case Manager- Case Management

    Arnot Health (Elmira, NY)
    …to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The ... is BSN prepared will be a leader in the Case Management practice. The Case ...care hospital setting or two years utilization management in an acute care hospital setting. Case more
    Arnot Health (05/08/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management certification or obtain a ... case reimbursement. a) Identifies cost/clinical outlier patients for intensive case management and facilitates evaluation of alternative care options. b)… more
    Guthrie (05/13/25)
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  • RN Case Manager - Case

    Guthrie (Corning, NY)
    …Has an understanding of the regulatory requirements relative to the case management process. Certified to complete Patient Review Instruments (PRIs). Has a ... working knowledge of the hospital computer system as it relates to case management . Essential Functions: 1. Assists to ensure that the right care is provided to… more
    Guthrie (05/14/25)
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  • RN/ Case Manager-Inpatient-Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …limited to:** + Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using ... Manager (CM) will be responsible for all aspects of case management for an assigned group of...in homecare, long term care or utilization review preferred. + Discharge Planner or Case more
    Mount Sinai Health System (05/08/25)
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  • Nurse Case Manager: Full Time, DAYS

    Albany Medical Center (Albany, NY)
    …of clinical experience in an assigned service - required + Recent experience in case management , utilization management and/or discharge planning/home ... with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use...cases and selected patient care groups. + Collaborates with case management leadership to compile and report… more
    Albany Medical Center (05/08/25)
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