• Clinical Review Nurse

    Centene Corporation (New York, NY)
    …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
    Centene Corporation (08/02/25)
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  • Insurance Specialist - Samaritan Hospital - PD…

    Trinity Health (Troy, NY)
    …administrative requirements for Utilization Management and works collaboratively with Utilization Management/ Concurrent Review Nurse , physicians, staff and ... possible concurrent denials, forwards information to the appropriate Utilization Management/ Concurrent Review Nurse within identified process standards *… more
    Trinity Health (07/26/25)
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  • Trauma Performance Improvement Coordinator

    UHS (Johnson City, NY)
    …perspective. The Trauma Performance Improvement Coordinator will conduct retrospective and concurrent case reviews of the critically injured patient from time of ... Minimum Required: + Bachelor's in Nursing or related Healthcare field . Preferred: + 5 years of clinical experience in...Current CPR Certification. + Current provider certification in Trauma Nurse Core Course (TNCC) or Advanced Trauma Care for… more
    UHS (07/09/25)
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  • Clinical Documentation Specialist

    Kaleida Health (Buffalo, NY)
    …team, Nursing, Patient Management, Quality Department and ancillary staff to perform concurrent analytical review of clinical documentation and coding data.The ... of the health care team. The CDS is also responsible for audit review to identify potential documentation deficiencies in specific records and to identify clinical… more
    Kaleida Health (08/08/25)
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  • RN Case Manager - Case Management - Full Time Day

    Guthrie (Corning, NY)
    …a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or BA degree ... hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who holds a bachelor's...experience, who holds a bachelor's degree in a related field . Experience: Must be able to communicate effectively and… more
    Guthrie (06/24/25)
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  • Case Mgr, RN- Case Management

    Northwell Health (Staten Island, NY)
    …to another level of care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for ... Sheet and the Patient Transfer Sheet. + Ensures Patient Review Instrument (PRI) is completed and reflects clinical profile...+ Current license to practice as a Registered Professional Nurse in New York State. + Case Management Certification,… more
    Northwell Health (08/21/25)
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  • RN Acute Case Manager - System Care Management…

    Guthrie (Binghamton, NY)
    …a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or BA degree ... hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who holds a bachelor's...experience, who holds a bachelor's degree in a related field . Experience: BSN or BA with a minimum of… more
    Guthrie (08/12/25)
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