• Commercial Review Specialist I

    SUNY Upstate Medical University (Syracuse, NY)
    …preparing regulatory notices for delivery to the patient Minimum Qualifications: NYS Licensed/ Registered (or eligible) RN , Bachelor's Degree in Nursing, and a ... This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure patients are...minimum of three years post RN licensure acute care nursing experience, or Associate's Degree… more
    SUNY Upstate Medical University (11/18/25)
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  • Pediatric Clinical Case Manager

    SUNY Upstate Medical University (Syracuse, NY)
    …coordinating, facilitating and monitoring resources to achieve optimal clinical outcomes, utilization of services and financial goals. Oversees the discharge process ... discharge services that are available. Minimum Qualifications: NYS licensed RN (or eligible), Bachelor's degree in Nursing or a...plus a minimum of three (3) years acute care RN or acute care, transitional care, or chronic care… more
    SUNY Upstate Medical University (12/02/25)
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  • Admissions/Discharge Nurse - Fulltime…

    Bassett Healthcare (Cooperstown, NY)
    …and enjoy the best quality of life possible. What you'll do The Discharge Nurse is accountable for the delivery of safe patient care utilizing the nursing process. ... The Discharge Nurse assesses, plans, delivers, coordinates, integrates, and evaluates nursing...and managerial observation + Demonstrates consideration of safety, effective utilization of equipment and materials, and cost in managing… more
    Bassett Healthcare (11/03/25)
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  • Transplant Care Nurse (Remote)

    Highmark Health (Albany, NY)
    …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or… more
    Highmark Health (01/10/26)
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  • Care Manager - Readmission Specialist

    Stony Brook University (Stony Brook, NY)
    …hospitalized patients who may be at a high risk for readmission. The RN following these patients must have good clinical and communication skills to address ... the case management plans such as clinical needs, barriers, utilization of resources via assessments and/or progress notes. *...analysis * Adheres to all State and Federal requirements, RN license, JACHO, CMS and DOH regulations. * Maintain… more
    Stony Brook University (12/20/25)
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  • Pediatric Ambulatory Clinical Case Manager

    SUNY Upstate Medical University (Syracuse, NY)
    …care across the continuum to achieve optimal clinical outcomes and efficient utilization of healthcare services. This role focuses on providing comprehensive care ... post-discharge services that are available. Minimum Qualifications: NYS licensed RN (or eligible), Bachelor's degree in Nursing or a...plus a minimum of three (3) years acute care RN or acute care, transitional care, or chronic care… more
    SUNY Upstate Medical University (12/24/25)
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  • Clinical Case Manager

    SUNY Upstate Medical University (Syracuse, NY)
    …coordinating, facilitating and monitoring resources to achieve optimal clinical outcomes, utilization of services, and financial goals. The Clinical Case Manager ... appropriate discharge plan/plan of care. Minimum Qualifications: NYS licensed RN (or eligible), Bachelor's degree in Nursing or a...plus a minimum of three (3) years acute care RN or acute care, transitional care, or chronic care… more
    SUNY Upstate Medical University (11/24/25)
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  • Resident Care Supervisor - Fox Nursing Home

    Bassett Healthcare (Oneonta, NY)
    …philosophy of the department + Consults with residents/families though primary nurse request, direct family request, and/or direct assessment of resident/family ... efficient fiscal management of department operations to ensure proper utilization of organizational and financial resources + Responsible for...2 Year / Associate Degree and Current registration as RN in NYS, required + 4 Year / Bachelor's… more
    Bassett Healthcare (11/03/25)
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  • Director-Care Mgmt

    Catholic Health Services (Roslyn, NY)
    …Then you have what it takes to be a St. Francis Hospital & Heart Center(R) RN . You are at the heart of health. St. Francis Hospital, The Heart Center(R) is New ... compliance with regulatory and external review agencies. + Participates in the Utilization Management Committee, reporting data on utilization trends, resource … more
    Catholic Health Services (01/08/26)
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  • Appeals Nurse

    Evolent (Albany, NY)
    …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
    Evolent (12/24/25)
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