• Coordinator, Utilization Management

    Evolent (Albany, NY)
    …contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager , Utilization ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing… more
    Evolent (05/03/25)
    - Related Jobs
  • RN Manager Healthcare Services…

    Molina Healthcare (Yonkers, NY)
    …Nurse who be licensed in the state they reside. We are looking for a RN Manager to manage a utilization management team supporting 14 Marketplace plans. Home ... - Flexibility to cover any weekend time if needed Preferred candidate with Utilization Management and leadership experience (Direct Reports) Compact RN license… more
    Molina Healthcare (05/10/25)
    - Related Jobs
  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management more
    Helio Health Inc. (05/02/25)
    - Related Jobs
  • Registered Nurse Care Manager

    Catholic Health (Buffalo, NY)
    …Holiday Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse (RN) Care Manager - Utilization Review, as an active member of the Care Management and ... foundational nursing clinical skills and discharge planning principles, the RN Care Manager , Utilization Review collaborates with the interdisciplinary team to… more
    Catholic Health (05/01/25)
    - Related Jobs
  • CHS Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …Health was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the...as liaison between the Utilization and Appeals Management Department and the physician of record, as required.… more
    Catholic Health Services (03/19/25)
    - Related Jobs
  • Care Manager (RN) - Center for Refugee…

    Rochester Regional Health (Rochester, NY)
    …the quality of care. The Care Manager actively participates in the utilization management process using standards of care to determine the most appropriate ... Job Title: Care Manager (RN) - Center for Refugee Health Location:...* 3 years of acute hospital care, Nursing, Case Management , or Utilization Management experience… more
    Rochester Regional Health (04/26/25)
    - Related Jobs
  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    … of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case Manager 's average ... BSN prepared will be a leader in the Case Management practice. The Case Manager will work...nursing in acute care hospital setting or two years utilization management in an acute care hospital… more
    Arnot Health (05/08/25)
    - Related Jobs
  • RN/Case Manager -MSH-Case Management

    Mount Sinai Health System (New York, NY)
    **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case management for an ... utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management more
    Mount Sinai Health System (04/15/25)
    - Related Jobs
  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …five (5) years of experience in an acute care setting with strong care management , utilization review, and payer knowledge. A Case Management certification ... Position Summary: The Acute Case Manager utilizes industry accepted processes for achieving optimal...members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria.… more
    Guthrie (02/11/25)
    - Related Jobs
  • Manager Case Management (Registered…

    Crouse Hospital (Syracuse, NY)
    …day management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... outreach programs. Crouse's Care Coordination team is hiring a Manager who is responsible for providing day to day... who is responsible for providing day to day management of the RN Care Managers in the department.… more
    Crouse Hospital (05/07/25)
    - Related Jobs