• Leader, Concurrent Review

    MVP Health Care (Schenectady, NY)
    …Workplace** . **Qualifications you'll bring:** + Current and unrestricted NY, VT RN license. + Associate or bachelor's degree in nursing (BSN preferred). + ... Minimum 4 years of clinical nursing experience. + At least 2 years in...and UM platforms. + Familiarity with CMS regulations and appeals processes. + Strong communication, conflict resolution, and organizational… more
    MVP Health Care (10/12/25)
    - Related Jobs

  • Community Health Assessment Field Nurse…

    Excellus BlueCross BlueShield (Rochester, NY)
    …the use of medical and health care services for members. The SN CHA Nurse may also perform other technical and administrative tasks essential to the efficient ... expert and occasionally works directly with the operation and clinical staff to resolve issues and escalated problems. +...other functions as assigned by management. Minimum Qualifications: + RN with valid and current NYS Nursing Licensure. +… more
    Excellus BlueCross BlueShield (09/27/25)
    - Related Jobs

  • Managed Care Coordinator

    Elderwood (Waverly, NY)
    …handles Third Party appeals , peer to peers as applicable and with clinical oversight provided by the LPN/ RN MDS Coordinator. Attends team meetings at ... Overview Mon-Fri 8am-4pm The Managed Care Coordinator assists and supports the LPN/ RN MDS Coordinator with case management responsibilities. The candidate is the… more
    Elderwood (10/07/25)
    - Related Jobs