• RN Care Manager Remote with field travel…

    Molina Healthcare (NY)
    …behavioral health settings. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must ... service. This position will be supporting our Washington State Medicare plan. We are seeking a candidate with previous...candidate with previous Case Management experience and a WA RN licensure. The candidate should have proficient knowledge of… more
    Molina Healthcare (08/08/25)
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  • Field Care Manager, Ltss ( RN )

    Molina Healthcare (NY)
    …for a Texas licensed RN to join Molina to work with our Medicare members in the San Antonio service delivery area; candidates should reside in Bexar County. ... health settings. + Required License, Certification, Association + Active, unrestricted State Registered Nursing license ( RN ) in good standing + If field… more
    Molina Healthcare (07/20/25)
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  • RN Case Manager

    Stony Brook University (Stony Brook, NY)
    …coverage as needed and other duties as required. **Qualifications** **Required** : Current NYS RN . A Bachelor's degree or a nurse working on their degree with ... RN Case Manager **Position Summary** At Stony Brook...Documents over utilization of resources and services. + All Medicare cases are reviewed for level of care on… more
    Stony Brook University (07/16/25)
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  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (Albany, NY)
    …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied ... these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
    Molina Healthcare (08/15/25)
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  • Transitional Care RN - Case Management…

    Mohawk Valley Health System (Utica, NY)
    …Management experience Licensure/Certification Requirements REQUIRED: + Current NYS Licensed Registered Professional Nurse . Disclaimer Qualified applicants will ... Transitional Care RN - Case Management - Full Time -...+ Implement post-discharge plans in accordance with criteria for Medicare , Medicaid coverage, HMO or private insurers. + Collaborate… more
    Mohawk Valley Health System (07/09/25)
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  • RN , Clinical Manager

    HCR Home Care (Rochester, NY)
    …$89,000.00 - $99,000.00 Annually Role and Responsibilities The Clinical Manager is an RN who supervises a potentially interdisciplinary team of RNs and LPNs to ... in nursing required . Qualifications and Requirements + Valid RN license issued by NYS Department of Education required...years' experience in certified home health care . + Medicare home health experience and management experience . +… more
    HCR Home Care (08/21/25)
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  • RN Physician Network

    Finger Lakes Health (Seneca Falls, NY)
    …promote comfort and healing and achieve the best possible clinical outcomes. The Registered Professional Nurse will use nursing process and approved nursing ... USA Pay Range $34.48 - $40.03 Job Description Under the direction of the RN Supervisor LMA, and in accordance with the approved policies and procedures, provides… more
    Finger Lakes Health (07/09/25)
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  • Utilization Manager Reviewer, RN (Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …development and promotional opportunities. All Levels + Associates degree and active NYS RN license required. Bachelors degree preferred. + Minimum of three years of ... managed care benefit plans and strong knowledge of government program contracts ( Medicare and Medicaid) and benefits, preferred. + Strong written and verbal… more
    Excellus BlueCross BlueShield (08/23/25)
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  • RN - Cfss - Hybrid Schedule (Home Care…

    HCR Home Care (Plattsburgh, NY)
    …+ Bachelor's Degree in Nursing preferred. Qualifications and Requirements + Current, valid RN license, issued by NYS Department of Education required. + Two (2) ... and be able to problem-solve effectively. + Possess knowledge of the Medicare guidelines governing home health agencies. + Organized, detail-oriented and possesses… more
    HCR Home Care (08/16/25)
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  • MDS - Nurse Assessment Coordinator…

    National Health Care Associates (Melville, NY)
    …USD $58.00/Hr. **-** **What You'll Bring:** **Qualifications of a MDS Coordinator / Nurse Assessment Coordinator include:** + Valid state RN nursing license + ... **-** **What You'll Do:** As an MDS Coordinator / Nurse Assessment Coordinator, you will complete and assure the...Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid and Medicare requirements helpful + Interest in the nursing needs… more
    National Health Care Associates (08/15/25)
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