• Case Manager - Case

    Arnot Health (Elmira, NY)
    …Bachelor's in nursing preferred. Must have proficient writing skills.Experience in Utilization Review and InterQual required. CARDIOPULMONARY RESUSCITATION (CPR) ... for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and...FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and retrospective… more
    Arnot Health (08/08/25)
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  • Case Manager

    Garnet Health (Harris, NY)
    …both city and rural life, we invite to make your career home with us as a Case Manager on our Case Management team at/in Garnet Health Medical Center ... of care from the hospital to home setting. Responsible for discharge planning, utilization review , team conferences and unit based rounds. At Garnet Health,… more
    Garnet Health (09/27/25)
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  • Registered Nurse Case Manager

    Northwell Health (Mount Kisco, NY)
    …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + Submits ... data to management regarding case management and/or quality initiatives. + Serves as an...collaboration with the health care team. + Conducts chart review for appropriateness of admission and continued length of… more
    Northwell Health (08/29/25)
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  • Case Manager - RN

    Calvary Hospital (Bronx, NY)
    …Spending, Transit Check. + Free On-Site Parking Requirements Participates in the Utilization Review , Discharge Planning, Risk Management, and Quality Assessment ... and Performance Improvement activities of the Department of Case Management. Assesses, plans, coordinates, implements and evaluates patient's health care needs… more
    Calvary Hospital (09/11/25)
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  • Nurse Case Manager

    Nuvance Health (Carmel, NY)
    …years RN experience in an acute care setting; Leadership experience preferred; Utilization review , discharge planning or case management experience ... preferred. Location: Carmel-PHC 670 Stoneleigh Avenue Work Type: Full-Time Standard Hours: 37.50 FTE: 1.000000 Work Schedule: Day 10 Work Shift: This is a Monday thru Friday position with rotating weekends. 8am-4pm Org Unit: 1168 Department: Care Coordination… more
    Nuvance Health (09/10/25)
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  • RN Clinical Manager

    CenterWell (Westbury, NY)
    …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and… more
    CenterWell (09/30/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Rochester, NY)
    …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified… more
    Molina Healthcare (09/06/25)
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  • Manager , Healthcare Services

    Molina Healthcare (Buffalo, NY)
    …experience. **Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management ... performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
    Molina Healthcare (09/27/25)
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  • Care Manager - Readmission Specialist

    Stony Brook University (Stony Brook, NY)
    …Documents the case management plans such as clinical needs, barriers, utilization of resources via assessments and/or progress notes. * Help connect the patient ... Care Manager - Readmission Specialist **_Position Summary_** _At Stony...to care * Prior experience with Care Management or Utilization Management * Understand levels of care including Inpatient,… more
    Stony Brook University (07/15/25)
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  • Registered Nurse Care Manager Transition…

    Catholic Health (Kenmore, NY)
    …acute care and/or community health nursing + Preferred prior insurance /managed care/ utilization review experience in the role of a Case Manager or ... Manager , Population Health, Discharge Planning or Chronic Care Manager KNOWLEDGE, SKILL AND ABILITY + Possesses case... Manager KNOWLEDGE, SKILL AND ABILITY + Possesses case management skills critical to working on an interdisciplinary… more
    Catholic Health (09/03/25)
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