• Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …Provides first level RN review for all outpatient and ancillary prior authorization requests for medical appropriateness and medical necessity using ... NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all outpatient and… more
    Centene Corporation (10/03/25)
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  • Nurse Coordinator - Therapeutic Foster Care…

    Hillside Family of Agencies (NY)
    …of youth/individuals. This role may also include performing all clinical functions of a Registered Nurse ( RN ). This is a full-time (40 hours) position, ... and support in an OCFS funded program! * Valid Registered Nurse ( RN ) license *...obtain medical/psychiatric history, establish health care needs, and complete prior authorization for medications or medical necessity… more
    Hillside Family of Agencies (09/23/25)
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  • LPN Care Coordinator - Hereditary Risk Program…

    Guthrie (Binghamton, NY)
    …safe and timely dispensing of the medication for the patient as needed. Medication Prior Authorization + Collect necessary documentation and submit it to the ... needed for patient that have arrived without orders. Prepare educational materials for the RN Nurse Navigator for Chemo Education Visits per the instruction and… more
    Guthrie (09/09/25)
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  • LPN Care Coordinator - Cancer Center - Full Time

    Guthrie (Corning, NY)
    …safe and timely dispensing of the medication for the patient as needed. Medication Prior Authorization * *Collect necessary documentation and submit it to the ... needed for patient that have arrived without orders. Prepare educational materials for the RN Nurse Navigator for Chemo Education Visits per the instruction and… more
    Guthrie (08/08/25)
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  • Utilization Management Nurse Consultant

    CVS Health (NY)
    …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... At least 1 year of Utilization Management experience in concurrent review or prior authorization . + Strong decision-making skills and clinical judgment in… more
    CVS Health (10/02/25)
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  • Utilization Review Nurse

    CDPHP (Latham, NY)
    …responsible for the clinical review and documentation for services requiring prior authorization . This includes approval determinations and appropriate ... nationally recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York State license required. +… more
    CDPHP (09/23/25)
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  • Associate Director, Provider Engagement - Oncology…

    Evolent (Albany, NY)
    …Managers to ensure successful adoption and engagement of Evolent's solutions (ie, prior authorization , clinical pathways) to ensure timely patient access to ... and/or practice transformation + Highly preferred oncology clinical experience (ie, RN , NP) + Must demonstrate knowledge of healthcare delivery operations,… more
    Evolent (07/25/25)
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  • Medical Assistant

    Charles B. Wang Community Health Center (Queens, NY)
    …patient care and support + Perform nursing tasks under the direction of the registered nurse or authorized health care providers + Interview patients and records ... + Demonstrate curiosity and understanding of patient registration, administrative workflows and prior authorization processes + Collaborate with the care team to… more
    Charles B. Wang Community Health Center (08/07/25)
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  • RN Care Manager - Full Time Days

    Trinity Health (Albany, NY)
    …ass needed **What you will need:** **Required:** + A current license to practice as a Registered Nurse ( RN ) in the State of New York + Associate's degree ... well as insurance companies to manage insurance verifications and prior authorizations + Continual review and authorization ...long term care facility or home care as a RN + Prior experience in case management… more
    Trinity Health (09/06/25)
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  • 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. ... Time** If you are looking for a phone triage RN II position in a busy Cardiology Office, this...- Friday Office Hours **What you will do:** The ** Registered Professional Nurse ** has the responsibility and… more
    Trinity Health (09/17/25)
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