• RN Case Manager - Case Management…

    Guthrie (Corning, NY)
    …Has an understanding of the regulatory requirements relative to the case management process. Certified to complete Patient Review Instruments (PRIs). Has ... and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates… more
    Guthrie (09/23/25)
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  • Case Manager RN

    Bassett Healthcare (Oneonta, NY)
    …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... efficient delivery of care in appropriate setting. + Completes utilization management and quality screening for assigned...both areas. + Refers cases and issues to Case Review , Utilization Committee, Medical Director, and Director… more
    Bassett Healthcare (09/18/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Rochester, NY)
    …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years… more
    Molina Healthcare (09/06/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …provided by the Case Manager include, but are not limited to, utilization review , case management , care transition, collaboration with physicians and ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for case management ...experience in a hospital environment preferred. + Previous case management , utilization review , and discharge… more
    Ellis Medicine (09/11/25)
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  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    …Bachelor's in nursing preferred. Must have proficient writing skills.Experience in Utilization Review and InterQual required. CARDIOPULMONARY RESUSCITATION (CPR) ... Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal...FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and retrospective… more
    Arnot Health (08/08/25)
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  • Audit Manager II Treasury and Balance Sheet…

    TD Bank (New York, NY)
    …for this role. **Line of Business:** Audit **Job Description:** The Audit Manager is accountable for overseeing the planning and execution for audits covering ... + Performs testing of critical areas of audit. Performs review of audit documentation. Oversees findings follow up and...subject matter expertise. + Acts as primary contact with management regarding audit scope, findings and status **Education &… more
    TD Bank (09/21/25)
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  • Manager , Healthcare Services

    Molina Healthcare (Buffalo, NY)
    …integrated) performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical ... of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and...years in one or more of the following areas: utilization management , case management , care… more
    Molina Healthcare (09/27/25)
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  • RN Clinical Manager

    CenterWell (Liverpool, NY)
    …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
    CenterWell (09/27/25)
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  • Property Manager 1/ Trainee 1/2 (NY Helps),…

    New York State Civil Service (Schenectady, NY)
    NY HELP Yes Agency Workers' Compensation Board Title Property Manager 1/ Trainee 1/2 (NY Helps), WCB item #252 Occupational Category Administrative or General ... Management Salary Grade 18 Bargaining Unit PS&T - Professional,...Duties Description Under the supervision of the Office Services Manager , SG-23, within the Office of Financial Services Division,… more
    New York State Civil Service (09/30/25)
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  • Case Manager - Per Diem

    Stony Brook University (Stony Brook, NY)
    … Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... Case Manager - Per Diem **Position Summary** At Stony...cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to… more
    Stony Brook University (09/26/25)
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