• Assistant Director of Case Management

    Stony Brook University (Stony Brook, NY)
    …staff. **Qualifications** **Required Qualifications:** * Possession of license to practice as a registered nurse in New York State. * Master's degree with ... standards within the scope of Case Management including, outcomes management, utilization and appeal management, reporting/data analysis to leadership and staff.… more
    Stony Brook University (09/23/25)
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  • Care Review Clinician, Prior Authorization

    Molina Healthcare (Albany, NY)
    …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
    Molina Healthcare (09/18/25)
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  • Manager, Healthcare Services

    Molina Healthcare (Buffalo, NY)
    …identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), case... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of … more
    Molina Healthcare (09/27/25)
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  • Clinical Reviewer, Nurse - Cardiology

    Evolent (Albany, NY)
    …**Qualifications Required and Preferred:** + Current, unrestricted state licensure as a Registered Nurse - **Required** + Associate or Bachelors in Nursing (Must ... , you will be a key member of the utilization management team. We can offer you a meaningful...be a Registered Nurse ) - **Required** + You must...be a Registered Nurse ) - **Required** + You must be able to… more
    Evolent (09/28/25)
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  • Clinical Program Manager - Clinical Command Center…

    Mount Sinai Health System (New York, NY)
    …patient emergencies and supporting patient-centered care. **Qualifications** Must be a Licensed Registered Nurse , Physician Assistant or Nurse Practitioner ... of Patient Flow experience preferred 5. EPIC experience preferred. Registered Nurse Licensed NYS Registered ...8 hospitals and over 95 inpatient units. Promotes optimum utilization of system hospital beds by conducting rounds and… more
    Mount Sinai Health System (08/09/25)
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  • OR Nurse Manager

    Excelsior Orthopaedics Group (Amherst, NY)
    …and Qualifications + Bachelor's degree in nursing preferred; current license to practice as a registered nurse ( RN ) in NYS required. + CNOR preferred or in ... The Operating Room Nurse Manager is a registered nurse who provides leadership and coordination...targets related to on-time starts, turnaround time and OR utilization . + Responsible for leading and managing the OR… more
    Excelsior Orthopaedics Group (10/01/25)
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  • Mobile Professional Care Manager (Hybrid)

    UPMC (Jamestown, NY)
    …Counselor (LPC), Licensed Social Worker (LSW), Licensed Mental/Behavioral Health Professional, or Registered Nurse ( RN ) + CPR certification required based ... services field with a master's degree, or a licensed Registered Nurse . + Minimum of 3 years...3 years of experience in behavioral health, clinical care, utilization management, home care, discharge planning, or case management.… more
    UPMC (08/30/25)
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  • Discharge Planner

    Ellis Medicine (Schenectady, NY)
    …assist in utilization management activities under the direction of a registered nurse and/or social worker. Responsibilities include maintaining case files, ... Planner's primary function is to work with the Social Worker, Nurse Case Manager, or Utilization Management Nurse to facilitate patient discharge plans,… more
    Ellis Medicine (08/28/25)
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  • Clinical Denials and Appeals-Clinical Supervisor

    Catholic Health (Buffalo, NY)
    …finance, business management, operational analysis, information systems or related field + Registered Nurse with a four (4) year degree and Unrestricted ... payers) and internal stakeholders including, but not limited to, Utilization Review, Case Management, Clinical Documentation Integrity, Health Information...NYS RN license, preferred + Holds, or will obtain within… more
    Catholic Health (10/01/25)
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  • Staff Nurse CMH ER, .9 FT, 7pm - 7am

    UHS (Norwich, NY)
    Position OverviewThe Registered Nurse ( RN ) or Graduate Nurse (GN) protects, promotes, and optimizes health and abilities, prevention of illness and ... advocacy in the care of individuals and families. The RN or GN is responsible and accountable for compliance...professional development in accordance with the New York State Nurse Practice Act, United Health Services policies, ANA Scope… more
    UHS (09/30/25)
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