• Case Manager , Pediatrics…

    Excellus BlueCross BlueShield (Rochester, NY)
    …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... of consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and… more
    Excellus BlueCross BlueShield (11/03/25)
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  • Registered Nurse Case Manager

    Northwell Health (Sleepy Hollow, NY)
    …five (5) years of job entry date. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as ... + Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + Submits… more
    Northwell Health (11/08/25)
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  • Registered Nurse Clinical Care…

    Northwell Health (Bay Shore, NY)
    …and action. + * Acts as a liaison with patient's insurance carrier (case manager , utilization reviewer) to coordinate post hospital services and referrals. + * ... to the Hospital. Job Responsibility + * Performs concurrent review on all patients and share all problematic cases...field, preferred. + Current license to practice as a Registered Professional Nurse in New York State.… more
    Northwell Health (11/18/25)
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  • RN Supervisor Case Management - Full Time…

    Mohawk Valley Health System (Utica, NY)
    …care to our diverse member population. Provides direct oversight of the case manager 's daily operations of utilization review practice, processes and ... RN Supervisor Case Management - Full Time -...Performs related duties as assigned. Education/Experience Requirements REQUIRED: + Registered Nurse licensed in State of New… more
    Mohawk Valley Health System (10/07/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or ... of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who...in an acute care setting with strong care management, utilization review , and payer knowledge. A Case… more
    Guthrie (08/27/25)
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  • Medical Review Nurse ( RN )

    Molina Healthcare (Buffalo, NY)
    … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...clinical nursing experience, including at least 1 year of utilization review , medical claims review ,… more
    Molina Healthcare (10/18/25)
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  • RN Clinical Manager

    CenterWell (Westbury, NY)
    …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (09/30/25)
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  • Bone Marrow Transplant (BMT) Cellular Therapy…

    Mount Sinai Health System (New York, NY)
    …excellent communication and interpersonal skills. + Current license and registration as a Nurse Practitioner OR Professional Registered Nurse in NY State ... Title - Bone Marrow Transplant (BMT) Cellular Therapy Program Manager ( RN /NP) - Outpatient Oncology - Mount...manager supervises and directs a designated group of nurse clinical coordinators within the Bone Marrow Transplant and… more
    Mount Sinai Health System (10/23/25)
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  • Intake Coordinator- RN Lhtc/ Evenings

    Villa of Hope (Rochester, NY)
    …SUMMARY: Under the general direction of the Nurse Manager , the Intake Coordinator- RN is a Registered Nurse who will assist in supervising Clinical ... TITLE: Intake Coordinator- RN / Evening DEPARTMENT/PROGRAM: Medical Services SUPERVISOR: Nurse Manager /Health Coordinator PAY GRADE: 82 FLSA STATUS: NON… more
    Villa of Hope (11/02/25)
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  • Case Manager , RN (FH)

    Northwell Health (Forest Hills, NY)
    …in Case Management, preferred.Minimum five (5) years clinical experience as a registered nurse . Prior experience in utilization management and/or ... Degree, preferred.Current license to practice as a Registered Professional Nurse in New York State.Patient Review Instruments (PRI) Certification, preferred.… more
    Northwell Health (11/07/25)
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