• Supv, Assistant Nurse Manager - Nursing…

    Guthrie (Binghamton, NY)
    …role related to professional specialty. Education, License & Cert: Licensed as a Registered Nurse in the State of Pennsylvania/New York. Certification within ... hire. Experience: Two years of recent clinical supervisory experience or charge nurse experience desired Essential Functions: RESOURCE UTILIZATION : + Considers… more
    Guthrie (12/02/25)
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  • Administrator of Admissions, Outreach & Intake

    Calvary Hospital (Bronx, NY)
    …year Requirements QUALIFICATIONS: 1. Master of Nursing Degree required. 2. NYS unencumbered Registered Nurse License required. 3. Ten (10) to fifteen (15) years ... has been denied. Conducts interdepartmental meetings related to the quality and utilization of clinical services. Serves on various Hospital committees as assigned.… more
    Calvary Hospital (11/19/25)
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  • Appeals Manager

    BronxCare Health System (Bronx, NY)
    …response by the department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal ... the department's leadership develop strategies for denial prevention, improved utilization management, documentation of medical necessity and identify patterns and… more
    BronxCare Health System (11/15/25)
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  • Payment Integrity Clinician

    Highmark Health (Albany, NY)
    …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
    Highmark Health (11/14/25)
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  • Case Manager - AOMC

    Arnot Health (Elmira, NY)
    …of an approved registered nursing program with a current license as a registered nurse . BSN or Case Management Certification preferred. EXPERIENCE: Three to ... . The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case Manager's...The Case Manager tracks and trends LOS , resource utilization , outliers, readmissions , denials , delay days… more
    Arnot Health (11/06/25)
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  • Director Pre Appeals Management-HSO Appeals…

    Mount Sinai Health System (New York, NY)
    …Business, or related field strongly preferred + **Licensure/Certification** : + Active RN license in the state of employment required + Certification in Case ... Management (CCM, ACM) or Utilization Management preferred. + 7+ years of experience in...+ 7+ years of experience in clinical acute clinical, utilization management, appeals management or related operations + 3+… more
    Mount Sinai Health System (11/01/25)
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  • Direct Care Worker

    Acacia Network (Bronx, NY)
    …the necessary documentation are completed and return to review by the program registered nurse + Responsible for maintaining a clean and sanitary residence ... for residential appointments or any other individual needs which may require the utilization of the agency vehicle + Reads, initial and enter required information on… more
    Acacia Network (01/17/26)
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  • Direct Care Worker

    Acacia Network (New York, NY)
    …the necessary documentation are completed and return to review by the program registered nurse . + Responsible for maintaining a clean and sanitary residence ... for residential appointments or any other individual needs which may require the utilization of the agency vehicle. + Reads, initial and enter required information… more
    Acacia Network (01/17/26)
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  • Nursing Director; Behavioral Health

    Catholic Health Services (Smithtown, NY)
    …in Nursing, Business, Health, or allied field required. + Licensure/Certification: Licensed Registered Nurse , New York State + Skills, Knowledge or Abilities: ... staffing of assigned units, reviewing and approving monthly time sheets and maximum utilization of available staff with the authority to relocate staff as required.… more
    Catholic Health Services (01/17/26)
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  • Medical Assistant

    WMCHealth (Hawthorne, NY)
    …care using good judgment, methods, and skills under the direction of a Registered Nurse or Physician. Responsibilities: + Observes, monitors, and records ... and filing of confidential documents; and basic Internet and email utilization . + Participate in performance improvement activities, staff trainings, weekly team… more
    WMCHealth (01/16/26)
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