• 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 (07/25/25)
    - Related Jobs
  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    …related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case ... of self and other case managers. f. The Case Manager tracks and trends LOS, resource utilization ,...Case Manager tracks and trends LOS, resource utilization , outliers, readmissions, denials, delay days and satisfaction of… more
    Arnot Health (08/08/25)
    - Related Jobs
  • 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 FT 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 (07/15/25)
    - Related Jobs
  • Case Manager RN- Mount Sinai West- Full…

    Mount Sinai Health System (New York, NY)
    …preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... **Job Description** The Case Manager (CM) will be responsible for all aspects...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
    Mount Sinai Health System (08/09/25)
    - Related Jobs
  • Case Manager , RN- Rehab Comprehensive IRF

    Northwell Health (Staten Island, NY)
    …case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. + Keeps ... concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness of admission and continued length of stay. + Contacts… more
    Northwell Health (08/08/25)
    - Related Jobs
  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Yonkers, NY)
    …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level… more
    Molina Healthcare (08/08/25)
    - Related Jobs
  • RN Clinical Manager Home Health

    CenterWell (Hauppauge, NY)
    review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... at our Hauppauge, 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 (08/08/25)
    - Related Jobs
  • Case Manager - UM II -100%

    Healthfirst (NY)
    The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review , discharge ... planning, and case management as assigned. The Case Manager , Utilization Management is also responsible for efficient utilization of health services and… more
    Healthfirst (08/08/25)
    - Related Jobs
  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …(5) years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtain ... Position Summary: The Acute Case Manager utilizes industry accepted processes for achieving optimal patient, clinical, and operational outcomes timely, coordinated,… more
    Guthrie (08/12/25)
    - Related Jobs
  • RN Case Manager

    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 ... RN Case Manager **Position Summary** At Stony Brook Medicine, a...cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to… more
    Stony Brook University (07/16/25)
    - Related Jobs