• RN Supervisor Case Management - Full Time - Days

    Mohawk Valley Health System (Utica, NY)
    …care to our diverse member population. Provides direct oversight of the case manager 's daily operations of utilization review practice, processes and ... responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include the supervision… more
    Mohawk Valley Health System (07/09/25)
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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 social ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for case management of assigned...in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly… more
    Ellis Medicine (09/11/25)
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  • RN/Case Manager -MSH-Case…

    Mount Sinai Health System (New York, NY)
    …+ Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... **Job Description** **RN/Case Manager MSH Case Management PT Days** The Case...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
    Mount Sinai Health System (09/23/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Rochester, NY)
    …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience,… more
    Molina Healthcare (09/06/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtaining ... recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with… more
    Guthrie (08/27/25)
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  • Case Manager RN

    Bassett Healthcare (Oneonta, NY)
    …continuous improvement in both areas. + Refers cases and issues to Case Review , Utilization Committee, Medical Director, and Director of Quality in compliance ... and enjoy the best quality of life possible. What you'll do The Case Manager RN supports the physician and interdisciplinary team in facilitating patient care, with… more
    Bassett Healthcare (09/18/25)
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  • RN Clinical Manager

    CenterWell (Westbury, NY)
    …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... at our Westbury, NY branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
    CenterWell (09/30/25)
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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 ... Code 12305 Duties Description Under the supervision of the Office Services Manager , SG-23, within the Office of Financial Services Division, Facilities / Mailroom… more
    New York State Civil Service (09/30/25)
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  • Manager , Healthcare Services

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