• Registered Nurse Care Manager (NYC)

    Northwell Health (Manhasset, 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 ... plans + Applies clinical expertise and medical appropriateness criteria to resource utilization and discharge planning, and manages the resources necessary for cost… more
    Northwell Health (03/09/25)
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  • RN , Utilization Management

    University of Rochester (Rochester, NY)
    …experience including: Interqual, Sharepoint, eRecord, ePARC, Cobius preferred LICENSES AND CERTIFICATIONS - RN - Registered Nurse - State Licensure and/or ... Type: Full time Scheduled Weekly Hours: 40 Department: 500009 Utilization Management Work Shift: UR - Day (United States...Compact State Licensure NYS Registered Nurse license upon hire required The… more
    University of Rochester (04/12/25)
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  • Utilization Management RN

    Ellis Medicine (Schenectady, NY)
    Basic Function: The Utilization Management Registered Nurse (UM RN ) supports daily coordination of care across healthcare continuum with the healthcare ... preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures...care related field required. Current registration as a Licensed Registered Professional Nurse in New York State.… more
    Ellis Medicine (04/03/25)
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  • Utilization Management Reviewer I/II/III…

    Excellus BlueCross BlueShield (Utica, NY)
    …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of clinical… more
    Excellus BlueCross BlueShield (05/02/25)
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  • RN Utilization Review - System Care…

    Guthrie (Binghamton, NY)
    …care services regarding admissions, case management, discharge planning and utilization review. Responsibilites: Reviews admissions and service requests within ... needs with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversees and coordinates compliance to federally… more
    Guthrie (04/05/25)
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  • Assistant Director of Case Management/…

    Mount Sinai Health System (New York, NY)
    …the delivery of comprehensive front-line Case Management services, including utilization management, care facilitation and discharge planning. The Assistant Director ... of Case Management and 6 years as a clinical nurse . + Previous supervisory experience in case management or...in case management is preferred Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** 1.… more
    Mount Sinai Health System (04/04/25)
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  • Trainer - Clinical Services - Utilization…

    Molina Healthcare (Albany, NY)
    …knowledge on the job. Job Qualifications **REQUIRED EDUCATION** : Completion of an accredited Registered Nurse ( RN ) Program and an Associate's or Bachelor's ... settings. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted State Registered Nursing ( RN ) or State Clinical Social Worker/Counseling… more
    Molina Healthcare (05/07/25)
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  • Utilization Review Coordinator, (NY Helps),…

    New York State Civil Service (Buffalo, NY)
    …all requirements of non-competitive promotion are met.Promotional Field consists of Registered Nurse 1 Psychiatric (including all language parenthetic) ... NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), Greater Binghamton Health Center, P26033 Occupational Category Health… more
    New York State Civil Service (05/01/25)
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  • Utilization Review Coordinator, (NY Helps),…

    New York State Civil Service (Bronx, NY)
    …all requirements of non-competitive promotion are met.Promotional Field consists of Registered Nurse 1 Psychiatric (including all language parenthetic) ... NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York City Children's Center - Bronx Campus, P25595 Occupational… more
    New York State Civil Service (04/05/25)
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  • Utilization Management Nurse…

    CVS Health (Albany, NY)
    …both verbal and written **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care setting + Must have active ... current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and… more
    CVS Health (05/02/25)
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