• RN/Case Manager-MSH-Case Management…

    Mount Sinai Health System (New York, NY)
    …to: a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using standardized ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will...Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case… more
    Mount Sinai Health System (10/14/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care...in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to… more
    Guthrie (08/27/25)
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  • RN Supervisor Case Management - Full Time…

    Mohawk Valley Health System (Utica, NY)
    …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... - SNH is responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include… more
    Mohawk Valley Health System (10/07/25)
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  • Director of Nursing Professional Practice, RN…

    Mount Sinai Health System (New York, NY)
    …the Daily Management Board process/practice improvement activities to facilitate the utilization of evidence and data related to Nurse Sensitive Indicators ... **Job Description** The Director of Nursing Professional Practice is a professional nurse with broad knowledge and skill in the professional practice standards, NYS… more
    Mount Sinai Health System (10/13/25)
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  • Director of Care Management - Mount Sinai…

    Mount Sinai Health System (Long Island City, NY)
    **Job Description** The Director will direct and manage departmental activities involved in utilization review , appeals management and discharge planning to ... or healthcare-related field **Experience Requirements** 5 years of Case Management and 6 years of clinical nurse ...services by focusing on patient processes. 8.Develops and implements Utilization Review (UR) based on internal data… more
    Mount Sinai Health System (10/23/25)
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  • Quality Management Specialist I

    DePaul (Rochester, NY)
    …the Quality Management Plan within the corporation. + Incident Management - review incident reports and provide feedback and recommendations(site-specific). ... trends for reporting and follow-up consultation and training. + Responsible for Utilization Record Review functions to include Individual record audits,… more
    DePaul (10/10/25)
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  • Medical Director

    Molina Healthcare (Rochester, NY)
    … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
    Molina Healthcare (10/22/25)
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  • Medical Director (AZ)

    Molina Healthcare (NY)
    … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
    Molina Healthcare (10/17/25)
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  • Case Manager RN

    Bassett Healthcare (Cooperstown, NY)
    …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... efficient delivery of care in appropriate setting. + Completes utilization management and quality screening for assigned...both areas. + Refers cases and issues to Case Review , Utilization Committee, Medical Director, and Director… more
    Bassett Healthcare (10/21/25)
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  • VP Care Management Post-Acute Care…

    Kaleida Health (Buffalo, NY)
    …In addition to daily oversight of operations, the VP will partner with Utilization Review , Revenue Cycle, and Clinical leadership to create patient/family ... Business field preferred. RN licensure required.** **Experience** **10 years of care management / utilization management experience required in hospital and/or… more
    Kaleida Health (09/17/25)
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