• Case Manager - UM II -100%

    Healthfirst (NY)
    The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review, discharge planning, ... and case management as assigned. The Case Manager , Utilization Management is also responsible...necessary + Additional duties as assigned Minimum Qualifications: + RN , LPN, LMSW, LMHC, LMFT, LCSW, PT, OT, and/or… more
    Healthfirst (08/08/25)
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  • LTSS Service Coordinator - RN Telehealth

    Elevance Health (New York, NY)
    case within the scope of licensure; provides supervision and direction to non- RN clinicians participating in the member's case in accordance with applicable ... **LTSS Service Coordinator - RN Telehealth** **_Location:_** candidate must reside in the...chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of… more
    Elevance Health (05/18/25)
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  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (Albany, NY)
    …unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
    Molina Healthcare (08/15/25)
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  • Case Management Assistant

    WMCHealth (Valhalla, NY)
    …+ Maintain required documentation of work activities. + In collaboration with the case manager and care coordinator, implement the discharge review program ... Case Management Assistant Company: WMC Advanced Physician Services...Responsibilities: + Facilitate discharge planning referrals as guided by RN CM and SW across multiple units + Provide… more
    WMCHealth (08/02/25)
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  • Program Manager , HCS

    Molina Healthcare (Buffalo, NY)
    …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of ...**Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare… more
    Molina Healthcare (08/02/25)
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  • Nurse Navigator

    Catholic Health Services (Rockville Centre, NY)
    …Infusion Pharmacy Manger Perform other duties as directed by manager . Requirements: RN ( Registered Nurse ) - Diploma, Associates or Bachelor's degree from ... named Long Island's Top Workplace! Job Details Purpose: The Nurse Navigator - RN , is responsible for:...or school of nursing. Current licensure as a NYS Registered Nurse Must possess a valid and… more
    Catholic Health Services (08/15/25)
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  • Program Manager - Center of Excellence…

    Albany Medical Center (Albany, NY)
    …range: $86,650.99 - $134,309.04 We have an exciting opportunity for a Program Manager to join our multidisciplinary Team at the Albany Med Center of Excellence ... College, Department of Neurology and Director of Alzheimer's Program, the Program Manager will oversee the day-to-day clinical and administrative operations of the… more
    Albany Medical Center (05/26/25)
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  • Healthcare Risk Management - St Peters Health…

    Trinity Health (Albany, NY)
    …degree is strongly preferred). Master's degree preferred. Certification (CPHRM) is preferred. Registered Nurse preferred. Ideally, the candidate will have 3-5 ... visitors, vendors, various regulatory and professional agencies. **SUPERVISED BY:** Manager of Risk Management **SUPERVISES:** none **CAREER PATH:** Management… more
    Trinity Health (07/22/25)
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  • National Director, Care Integration Strategy…

    CenterWell (Albany, NY)
    …Senior Primary Care's) highest need and complexity patients with care and case management services. The Director is response for the strategic direction, execution ... Transitions of Care Management (TCM) program, and Episodic Consult (single-use case specific offerings) programs designed to improve quality and reduce costs… more
    CenterWell (08/15/25)
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