• Utilization Manager Reviewer, RN

    Excellus BlueCross BlueShield (Rochester, NY)
    …to the Medical Director for review. Refer to and work closely with Case Management to address member needs. Participates in rotating on-call schedule, as required, ... explaining processes for accessing Health Plan to perform medical review, obtains case or disease management support, or otherwise interacts with Health Plan… more
    Excellus BlueCross BlueShield (08/23/25)
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  • Telephonic Case Manager

    Sedgwick (Albany, NY)
    …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the ... injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a...on the health and lives of others, and a remote work environment. + Enjoy flexibility and autonomy in… more
    Sedgwick (09/19/25)
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  • Field Case Manager -Sign-On Bonus…

    Sedgwick (Albany, NY)
    …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Field Case Manager -Sign-On Bonus Eligible **We are growing all across the US and ... are looking for experienced Workers Comp Field Case Managers! Required to have a minimum of** **1.5...on the health and lives of others, and a remote work environment that allows face to face interaction… more
    Sedgwick (08/27/25)
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  • Operations Manager , VBCM- Remote

    Sharecare (Albany, NY)
    …of Sharecare with leadership practices. **Qualifications:** + Current licensure as a Registered Nurse is required; Compact state preferred + Bachelor's degree ... experience in Care/ Case Management + NCQA experience preferred + Certified Case Manager preferred + Prior management and supervision of a clinical team is… more
    Sharecare (07/30/25)
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  • Transition of Care Coach ( RN ) (Pacific…

    Molina Healthcare (Syracuse, NY)
    …ICT collaboration. + RNs provide consultation, recommendations, and education as appropriate to non- RN case managers. + RNs are assigned cases with members who ... Association** Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager (CCM) Work schedule :M - F Pacific… more
    Molina Healthcare (09/14/25)
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  • Medical Claim Review Nurse ( RN )

    Molina Healthcare (Rochester, NY)
    …ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (09/06/25)
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  • Disease Management Nurse - Remote

    Sharecare (Albany, NY)
    …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... the disease management program intervention guidelines. A Disease Management Nurse is supervised by an Operations Manager ...during the training period will be evaluated on a case by case basis and must be… more
    Sharecare (09/13/25)
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  • LVN Delegation Oversight Nurse

    Molina Healthcare (Rochester, NY)
    …skills. + Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** + Registered Nurse ( RN ). The license must be active ... + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or… more
    Molina Healthcare (09/20/25)
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  • Care Manager

    LIFEPlan CCO NY (Clifton Park, NY)
    …Arts or Science degree with two years of relevant experience, or a license as a Registered Nurse with two years of relevant experience, or a master's degree with ... Care Manager Job Details Level Experienced Job Location Clifton...preferred. Work with people with intellectual and/or developmental disabilities, case management, or in the Mental Health or Substance… more
    LIFEPlan CCO NY (09/28/25)
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  • Performance Monitor Specialist, Clinic

    Centene Corporation (New York, NY)
    …and Certifications:** A license in one of the following is required: Licensed Registered Nurse ( RN ), Licensed Clinical Social Worker (LCSW), Licensed ... Clinical Social Work/Counseling required OR Associate's degree and an RN with 3+ years of clinical experience. 3+ years...(LMHC), or Licensed Marital and Family Therapist (LMFT). Certified Case Manager (CCM) preferred.Pay Range: $55,100.00 -… more
    Centene Corporation (09/09/25)
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