• Medical Claim Review Nurse (RN)

    Molina Healthcare (Yonkers, NY)
    …ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified ... of payment decisions. + Serves as a clinical resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. +… more
    Molina Healthcare (08/08/25)
    - Related Jobs
  • RN Clinical Manager Home Health

    CenterWell (Hauppauge, NY)
    …to sit on-site at our Hauppauge, NY branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services provided by clinical ... the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case , including… more
    CenterWell (08/08/25)
    - Related Jobs
  • Appeals Manager

    BronxCare Health System (Bronx, NY)
    …electronic medical record systems and data entry into an electronic database system. The Appeal Manager should be a nurse who has 3-5 years or more of experience ... management, professional trade association, a closely related area is preferred. The Appeal Manager should have experience as a nurse in acute care clinical… more
    BronxCare Health System (06/21/25)
    - Related Jobs
  • Program Manager , HCS

    Molina Healthcare (Buffalo, NY)
    …experience. **Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management ... including 3 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management. + Minimum 2… more
    Molina Healthcare (08/02/25)
    - Related Jobs
  • Ambulatory Care Manager

    WMCHealth (West Nyack, NY)
    Ambulatory Care Manager Company: Bon Secours Charity Medical Group City/State: West Nyack, NY Category: Nursing/Nursing Management Department: Admin - Orange County ... Apply Now External Applicant link Internal Applicant link Job Details: The Ambulatory Care Manager is assigned to manage a panel of patients and work together with… more
    WMCHealth (07/24/25)
    - Related Jobs
  • Territory Manager - Montefiore

    ZOLL Medical Corporation (Bronx, NY)
    …include: Physicians (Cardiologists, Electrophysiologists, Hospitalists, CT Surgeons etc.), Nurse Practitioners, Physician Assistants, nurses, case managers ... with relevant clinical, reporting, and technical information that supports the utilization of ZOLL Cardiac Diagnostic products for appropriate patients. +… more
    ZOLL Medical Corporation (07/22/25)
    - Related Jobs
  • Care Delivery Manager Perm / Ridgewood,…

    FlexStaff (New York, NY)
    **Req Number** 155467 FlexStaff is looking for a Care Delivery Manager . JOB PURPOSE: Responsible for supporting the nursing standards of excellence with advance ... with the Virtual IDT as needed. Serve as a manager on call during non-operational hours of the physical...Clinical Delivery reports. Participates and represents the Community Health Nurse (CHN) in all IDT meetings, when required. Balance… more
    FlexStaff (07/08/25)
    - Related Jobs
  • Clinical Manager - Integrated Care Perm…

    FlexStaff (New York, NY)
    …from a supervisor. Minimum of five (5+) years of experience in care/ case management, disease management, population health management, utilization review, ... **Req Number** 156311 FlexStaff is seeking a qualified Clinical Manager - Integrated Care Perm position for two separate locations; Brooklyn and Bronx. This position… more
    FlexStaff (07/18/25)
    - Related Jobs
  • Care Delivery Manager

    CenterLight Health System (Ridgewood, NY)
    …Support and collaborate with the Virtual IDT as needed. + Serve as a manager on call during non-operational hours of the physical sites and was responsible for ... Delivery reports. + Participates and represents the Community Health Nurse (CHN) in IDT meetings, when required. + Balance...the effectiveness of the plan of care and the utilization of services and implements changes and adjustments to… more
    CenterLight Health System (08/08/25)
    - Related Jobs
  • RN - Care Delivery Manager - Contract

    FlexStaff (Flushing, NY)
    …Support and collaborate with the Virtual IDT as needed. - Serve as a manager on call during non-operational hours of the physical sites and responsible for follow ... Delivery reports. - Participates and represents the Community Health Nurse (CHN) in all IDT meetings, when required. JOB...the effectiveness of the plan of care and the utilization of services and implements changes and adjustments to… more
    FlexStaff (07/29/25)
    - Related Jobs