• Care Review Clinician, Prior

    Molina Healthcare (Buffalo, NY)
    …and its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
    Molina Healthcare (08/31/25)
    - Related Jobs
  • Care Review Clinician, Prior Auth (RN) Pega…

    Molina Healthcare (NY)
    …and its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
    Molina Healthcare (07/12/25)
    - Related Jobs
  • Advanced Registered Nurse Practitioner…

    STG International (Plattsburgh, NY)
    …or any other protected class. Medical Corps - 60J, 60L, 61F, 61H, 61N, 61R,62B Medical Specialist Corps - 65B, 65C, 65D Nurse Corps - 66B,66H, 66P Medical ... STGi is currently seeking a Nurse Practitioner (NP) or Physician Assistant (PA) to...duties include: ESSENTIAL FUNCTIONS: + Provides primary and preventive medical care to meet the needs (physical, mental, and… more
    STG International (08/08/25)
    - Related Jobs
  • Utilization Management Registered Nurse

    Humana (Albany, NY)
    …a team **Preferred Qualifications** + Bachelor's degree + Previous experience in prior authorization , claims, and/or utilization management in healthcare, health ... state registered nurse license + Minimum three, (3), years of Medical Surgery, Heart, Lung, maternity/obstetrics, or Critical Care Nursing experience required + … more
    Humana (09/04/25)
    - Related Jobs
  • Nurse Manager - Drug User Health

    Project Renewal, Inc. (New York, NY)
    Title: Nurse Care Manager for Drug User Health Services Location: Ft Washington Shelter (Manhattan) Salary: $110,000 - $120,000 Program Overview: Project Renewal ... our primary care and psychiatry clinics and our mobile medical vans and referrals to external providers. This treatment...C infection. Position Overview: Project Renewal is seeking a Nurse Care Manager (NCM) for Drug User Health Services… more
    Project Renewal, Inc. (09/06/25)
    - Related Jobs
  • Registered Nurse Scheduler - Vascular…

    Trinity Health (Syracuse, NY)
    …104 Union Ave ste 1005 Syracuse, NY 13203 MOC building 10th floor **Registered Nurse Scheduler** The RN Scheduler contributes to the overall success of the patient's ... role facilitates the scheduling of patients for surgery, tests, referrals, medical clearance including review of pre-op medication and health history. Through… more
    Trinity Health (06/24/25)
    - Related Jobs
  • Residential Assistant Nurse Manager…

    Hillside Family of Agencies (Rochester, NY)
    …to obtain medical /psychiatric history, establish health care needs, and complete prior authorization for medications or medical necessity based on ... $5,000 FULL-TIME REGISTERED NURSE SIGN-ON BONUS! Job Summary The Assistant ...is also responsible for providing health care oversight and medical care management for an identified caseload of youth… more
    Hillside Family of Agencies (08/15/25)
    - Related Jobs
  • Nurse Coordinator - Therapeutic Foster Care…

    Hillside Family of Agencies (NY)
    …to obtain medical /psychiatric history, establish health care needs, and complete prior authorization for medications or medical necessity based on ... NURSE SIGN ON BONUS! Job Summary The Nurse Coordinator provides health care oversight and medical... Nurse Coordinator provides health care oversight and medical case management for an identified caseload of youth/individuals.… more
    Hillside Family of Agencies (06/24/25)
    - Related Jobs
  • Utilization Review Nurse

    CDPHP (Latham, NY)
    …responsible for the clinical review and documentation for services requiring prior authorization . This includes approval determinations and appropriate ... exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care reviews, post-acute… more
    CDPHP (09/06/25)
    - Related Jobs
  • Nurse - Cardiology Office - Triage…

    Trinity Health (Albany, NY)
    …delivered when patients call with cardiac symptoms. Patient education via phone or nurse visits. Prescription refills, prior authorization for medicine. ... **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Nurse - RNII -Cardiology Office - Phone Triage...room, takes appropriate vital signs and documents in electronic medical record. + Review and update medication list to… more
    Trinity Health (09/02/25)
    - Related Jobs