• Licensed Master Social Worker - Emergency…

    Trinity Health (Syracuse, NY)
    …is a key stakeholder in the emergency room care transition team which includes nurse case managers, utilization review nurses, providers, and etc. whom ... Master's Degree from an accredited graduate school of social work. Licensed to practice as a Licensed Clinical Social Worker (LCSW) OR Licensed Master Social… more
    Trinity Health (07/11/25)
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  • Nurse -Psychiatric NP

    Northern Rivers Family Services (Troy, NY)
    …county and community partners, and participate in any quality audit and utilization review + Provide on-site/community based/home visits, medication evaluations, ... and education to staff + Prescribe medications, monitor, and review of drug regimen for enrolled individuals + Participate...adults diagnosed with mental illness. + Must be fully licensed Nurse Practitioner in the State of… more
    Northern Rivers Family Services (08/08/25)
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  • Case Manager Registered Nurse - Specialty…

    CVS Health (Albany, NY)
    …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
    CVS Health (08/10/25)
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  • Psychiatric Nurse Practitioner

    Wellpath (Valhalla, NY)
    …care through adherence to policies and procedures for admission and transfer, utilization review , and referrals. + Assumes responsibility and accountability for ... lives saved by Narcan. We offer ongoing training and development opportunities for licensed and unlicensed healthcare team members, and have best in class clinical… more
    Wellpath (07/23/25)
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  • Clinical Reviewer, Nurse - 9am -6pm PST

    Evolent (Albany, NY)
    …quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on ... Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current,… more
    Evolent (08/01/25)
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  • Manager Case Management (Registered Nurse )

    Crouse Hospital (Syracuse, NY)
    …requirements related to acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical, Dental, Vision, FSA, ... compliance with regulatory requirements and contractual agreements. Manager, Care Coordination Requirements: + Licensed as a Registered Nurse in New York State +… more
    Crouse Hospital (08/08/25)
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  • Registered Nurse Care Management Transition…

    Catholic Health (Buffalo, NY)
    …Two (2) years acute care RN experience required + Preferred prior insurance /managed care/ utilization review experience in the role of a Case Manager or Disease ... RN with BSW, BS Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York State + New York State PRI & Screen… more
    Catholic Health (07/02/25)
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  • Care Manager - Registered Nurse (NICU)

    Crouse Hospital (Syracuse, NY)
    …Care Coordination Services team is hiring a Care Manager (in the NICU) to review the services delivered to patients and compare it to evidence-based guidelines in an ... maintaining the quality of care. + Participates in the utilization management process using standards of care to determine...Manager Position Requirements: + Must have a current Registered Nurse (RN) license. + Graduate from an accredited nursing… more
    Crouse Hospital (07/03/25)
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  • Nurse Case Manager

    Brighton Health Plan Solutions, LLC (New York, NY)
    …certifications like Diabetes educator, Pediatric Nursing, Gerontological Nursing. * Current licensed Registered Nurse (RN) with state licensure; bachelor's ... services to its clients. Cases are maintained by the Nurse Case manager. The Nurse Case Manager...Case Management. * Determines appropriate care level and resource utilization for complex cases. * Facilitates discharge planning and… more
    Brighton Health Plan Solutions, LLC (07/18/25)
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  • Registered Nurse , 326 Rockaway

    RiseBoro Homecare Inc. (Brooklyn, NY)
    …potential of communities to thrive, no matter the odds EDUCATION AND EXPERIENCE + Licensed Registered Nurse + At least 2-3 years of relevant experience working ... ESSENTIAL DUTIES AND RESPONSIBILITIES The Registered Nurse will serve young adults and families with...to clients as needed + Assist clients with medication review and understanding directives from Primary Care Physicians (PCPs)… more
    RiseBoro Homecare Inc. (05/23/25)
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