• RN /Case Manager (Inpatient)-Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …clinical information requested by the managed care companies as part of the concurrent review in a timely fashion. 13. Provides clinical information requested ... **Job Description** ** RN /Case Manager (Inpatient) Mount Sinai Morningside FT Days...experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred.… more
    Mount Sinai Health System (11/05/25)
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  • Nurse Case Manager: Full Time, DAYS

    Albany Medical Center (Albany, NY)
    …knowledge of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or Compact State ... financial constraints. + Provides collaborative care management with the primary nurse in assessing for discharge planning needs, coordinating appropriate resources… more
    Albany Medical Center (11/25/25)
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  • Clinical Documentation Specialist ( RN…

    Northwell Health (Lake Success, NY)
    …to clarify clinical documentation in the patient's medical record through a concurrent review process throughout the patient's inpatient stay. 4.Requests ... of mortality, and complexity of care provided. Responsible for concurrent inpatient medical record reviews for Medicare, Medicaid and...of employment date. *Current License to practice as a Registered Professional Nurse in New York State… more
    Northwell Health (11/20/25)
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  • Case Mgr, RN Casual- Case Management

    Northwell Health (Staten Island, NY)
    …* Bachelor's Degree in Nursing, required. * Current license to practice as a Registered Professional Nurse in New York State. * Case Management Certification, ... to another level of care according to regulatory standards. * * Performs concurrent utilization management using Interqual criteria. * Conducts chart review for… more
    Northwell Health (11/21/25)
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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (New York, NY)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient...Care only: LMSW, LCSW, LMHC, LPC, LMFT, LMHP or RN required Pay Range: $26.50 - $47.59 per hour… more
    Centene Corporation (11/08/25)
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  • Supervisor, Utilization Management

    Centene Corporation (New York, NY)
    …of related experience. Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or ... license.** **Inpatient Utilization Management** **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical… more
    Centene Corporation (11/09/25)
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  • Clinical Documentation Specialist

    Kaleida Health (Buffalo, NY)
    …of Arts in Nursing or similar or Bachelors in Health care Administration required. Registered Nurse required. CDS must obtain CCDS credential within 12 months of ... experience in Patient Management, acute care, medical/surgical or ICU/ED as a licensed Registered Nurse required. 1 year of experience in Clinical Documentation… more
    Kaleida Health (11/07/25)
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  • Senior Clinical Doc Specialist

    Kaleida Health (Buffalo, NY)
    …that require leadership abilities.** **Education And Credentials** Bachelors degree required. Registered Nurse required. Cert. Clinical Doc Specialist (CCS) ... experience in Patient Management, acute care, medical/surgical or ICU/ED as a licensed Registered Nurse required. 5 years of experience in Clinical Documentation… more
    Kaleida Health (10/15/25)
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  • Professional, Behavioral Health

    MVP Health Care (Schenectady, NY)
    …Master's prepared and licensed mental health clinician (LMSW, LCSW, LMHC, etc.) or Licensed Registered Nurse ( RN ) required + New York State license required ... . The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental health and substance use treatment decisions. This individual… more
    MVP Health Care (11/27/25)
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  • Data Analyst I

    University of Rochester (Rochester, NY)
    …(RHIT) Program Preferred **_or_** + Licensure/credentials in clinical specialty such as Registered Nurse , Licensed Practical Nurse , or Emergency Medical ... reviewing patient charts for additional data indicators, and completion of concurrent data abstraction. + Coordinate with other program staff, departments, and… more
    University of Rochester (11/05/25)
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