• Nurse Appeals - Litigation & Legal Support

    Elevance Health (New Hyde Park, NY)
    ** Nurse Appeals - Litigation & Legal Support** **In Office Expectation:** This role is **Virtual** ; This role enables associates to work virtually full-time, with ... necessary and is dependent on court hearing schedules. The ** Nurse Appeals - Litigation & Legal Support** is responsible...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… more
    Elevance Health (12/22/25)
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  • House Supervisor - Per Diem, Nights

    Nuvance Health (Rhinebeck, NY)
    …Review Corporation (SRC) - Robotic Center of Excellence * Center for Medicare and Medicaid Services (CMS) - 5 Star Rating At Northern Dutchess Hospital, we pride ... *Education*: Graduate of approved school of nursing with degree in Registered Professional Nursing. BSN preferred. *Experience*: Minimum 1 year supervisory… more
    Nuvance Health (12/15/25)
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  • Case Manager

    Loretto Management Corporation (Jamesville, NY)
    …resident financial situation, referring to Finance Department as necessary, ie Medicaid application. Provides financial counseling as required. + Evaluates the ... services and to make sure all needs are being addressed. + Informs program RN of any discrepancies and/or changes to care plan and/or functional condition of… more
    Loretto Management Corporation (12/11/25)
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  • Support Broker (Part-Time)

    The ARC of Madison Cortland (Oneida, NY)
    …document services provided and maintain all plans and records according to Medicaid and NYS standards. + Monitor self-direction expenditures to ensure that spending ... Requirements EDUCATION and/or EXPERIENCE:Bachelor's degree in health/human service field or RN preferred; and one year experience working with people with a… more
    The ARC of Madison Cortland (12/10/25)
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  • Part Time - Social Worker LCSW- Eddy Senior Care

    Trinity Health (Schenectady, NY)
    …centers. Eddy SeniorCare serves as both payer (we provide their Medicare and Medicaid insurance) and provider (offering a full range of services--from primary care ... to home health care, transportation, adult day care, activities, social work, RN case management, nutrition, home delivered meals and medications and medical… more
    Trinity Health (12/08/25)
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  • Therapist MHOTRS

    Unity House (Troy, NY)
    …legal, and ethical standards. + Collaborate with the Clinical Director, NPP, RN , case managers, and other care professionals. + Facilitate group therapy sessions. ... documentation and electronic health records (EHR). + Familiarity with OMH programming and Medicaid billing strongly preferred. Benefits : 13 paid days off in your… more
    Unity House (12/07/25)
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  • Lead Product & Strategy Manager - Provider…

    Humana (Albany, NY)
    …execution without day-to-day oversight **Preferred Qualifications** + Background as a clinician ( RN , NP, PA, MD, PharmD, or similar) + Experience with population ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ **Equal… more
    Humana (12/04/25)
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  • Sr Manager Clinical UM Operations

    Healthfirst (NY)
    …Lead, coach, and develop UM managers overseeing interdisciplinary teams of registered nurses, social workers, clinicians, and coordinators Ensure UM operations meet ... field from an accredited institution or equivalent work experience NYS RN Demonstrated understanding of UM regulatory requirements, clinical review process, and… more
    Healthfirst (11/27/25)
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  • Outpatient Care Manager

    Stony Brook University (Stony Brook, NY)
    …an understanding of managed care trends, payer regulations and Medicare/ Medicaid criteria for services. + Active participation in performance improvement, ... in special projects or other duties as assigned. **Qualifications** **Required:** + RN Licensure in NY State + Outpatient community service experience + Experience… more
    Stony Brook University (11/20/25)
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  • Case Management Representative

    Saratoga Hospital (Saratoga Springs, NY)
    …more experience in healthcare or related field. Clinical nursing background ( RN ) preferred. Knowledge regarding health insurance health insurance programs and/or ... facilitated enrollment (ie Medicaid ) a plus. Basic mathematical skills required. Solid working knowledge of Microsoft Office is required. Special Equipment, Skills… more
    Saratoga Hospital (11/01/25)
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