• RN Care Review Clinician

    Molina Healthcare (Albany, NY)
    JOB DESCRIPTION **Job Summary** The Care Review Clinician RN provides support for clinical member services review assessment processes. Responsible for ... Candidates with MCO experience are highly preferred. The Care Review Clinician must be able to work...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/26/25)
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  • RN Care Review Clinician

    Molina Healthcare (Albany, NY)
    JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for ... 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Buffalo, NY)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Rochester, NY)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
    Molina Healthcare (11/27/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Syracuse, NY)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
    Molina Healthcare (11/21/25)
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  • Utilization Review Clinician

    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 ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to...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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  • Denials Prevention Specialist, Clinician

    Datavant (Albany, NY)
    …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... is to effectively defend utilization of available health services, review of admissions for medical necessity and necessity of...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
    Datavant (11/12/25)
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  • Social Worker - Inpatient Behavioral Health

    Garnet Health (Harris, NY)
    … units. Frequent contacts with: law enforcement personnel, EMS, Medical Center security, ED RN staff, and family members. SW Clinician - is also responsible to ... make your career home with us as a Social Worker on our Inpatient Behavioral Health Unit (BHU) team at/in Garnet Health Medical Center-Catskill. Responsibilities The… more
    Garnet Health (11/25/25)
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  • Mechanical Circulatory Support Coordinator

    Albany Medical Center (Albany, NY)
    …and resolve potential problems to ensure the continuity of appropriate patient care. + RN - Registered Nurse - State Licensure and/or Compact State ... States of America) Salary Range: $86,650.99 - $134,309.04 The Inpatient Mechanical Circulatory Support Coordinator under guidance and in...Upon Hire - required + CCRN - Critical Care Registered Nurse (Adult, Neonatal, and Pediatric Acute)… more
    Albany Medical Center (09/20/25)
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  • Director, Clinical Documentation Improvement…

    Rochester Regional Health (Rochester, NY)
    …experience preferred. + Experience with EPIC preferred. EDUCATION: BS LICENSES / CERTIFICATIONS: RN - Registered Nurse - New York State Education ... proven leadership and management skills to promote effective and efficient review of physician documentation and the medical record. + Demonstrate knowledge… more
    Rochester Regional Health (10/04/25)
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