• Social Work Care Manager

    Elderwood (Buffalo, NY)
    …Responsibilities In the role of an Social Work Care Manager, you will partner with the Registered Nurse and are a critical resource for our members as you are ... may require interventions. + Participate in Interdisciplinary Team meetings, Disease Management , Utilization Management , and Quality Improvement activities… more
    Elderwood (12/11/25)
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  • Appeals Manager

    BronxCare Health System (Bronx, NY)
    …assist the department's leadership develop strategies for denial prevention, improved utilization management , documentation of medical necessity and identify ... avoidable day and barriers to discharge processes pertaining to utilization management . - Liaisons and coordinates with...department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager… more
    BronxCare Health System (11/15/25)
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  • MDS Coordinator

    WMCHealth (Warwick, NY)
    …accredited School of Nursing, BSN Preferred Licensure/Certifications: Valid and current NYS Registered Nurse and MDS AANAC Certification Preferred If applicable, ... to ensure facility compliance with Nursing Care Standards as applied to Resource Utilization Groups. The MDS Nurse assume responsibility for accurate completion… more
    WMCHealth (12/12/25)
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  • Surgical Core Tech - Thursday- Sunday 10am-8:30pm

    Albany Medical Center (Albany, NY)
    …and accurately. The Core Tech will support an integrated SPD/Sterile core/Supply Chain Management function in the operating room. Functions in the OR setting under ... the direction of the OR RN clinical manager(s). Assures surgeons' needs as identified on...as a liaison between the Surgery departments, SPD, Materials Management , and Clinical Engineering departments as necessary to assure… more
    Albany Medical Center (12/10/25)
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  • Care Manager - Readmission Specialist

    Stony Brook University (Stony Brook, NY)
    …multidisciplinary care is provided to the patients. * Documents the case management plans such as clinical needs, barriers, utilization of resources via ... with barriers to care * Prior experience with Care Management or Utilization Management *..._ * _ _Bilingual_ _ * _ _Certified in Case Management , UM, Quality, Risk or MCG_… more
    Stony Brook University (12/20/25)
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  • Health Home Care Manager II

    HCR Home Care (Canton, NY)
    …using the development of person-centered goals, culturally competent care management , and professional healthcare and social service coordination. Health Home ... Manager, capable of exceeding the basic tenants of care management . Essential Functions + Actively and progressively care manage...and short - term plans, when appropriate, including the utilization of community support with the goal of reducing… more
    HCR Home Care (10/18/25)
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  • Managed Care Coordinator

    Elderwood (Waverly, NY)
    …Coordinator Overview Mon-Fri 8am-4pm The Managed Care Coordinator assists and supports the LPN/ RN MDS Coordinator with case management responsibilities. The ... all types of communication (eFax, email, scan documents, phone calls) with case managers to provide concurrent updates as requested by Insurance Companies, handles… more
    Elderwood (12/11/25)
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  • Social Worker - Emergency Department

    Garnet Health (Harris, NY)
    …Health Medical Center - Catskills Emergency Department. Additionally will provide case management , and discharge planning for non-psychiatric patients. The ... as necessary. Maintaining administrative records related to emergency evaluations and case management . Close collaboration with ED physician and other… more
    Garnet Health (12/08/25)
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  • Sr Manager Clinical UM Operations

    Healthfirst (NY)
    **Duties/Responsibilities:** Provide strategic oversight and operational management for all utilization management functions, including prior authorization, ... for audits, performance improvement plans, and corrective actions related to utilization management Foster a culture of accountability, professional development,… more
    Healthfirst (11/27/25)
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  • Radiology Clinical Account Manager - Albany

    Hologic (Syracuse, NY)
    …+ Candidates with backgrounds such as Radiology Technologists, Mammography Technologists, Registered Nurses ( RN ), or other clinical professionals are strongly ... Technology and National Accounts to optimize customer experience. + Educate through case coverage, in-services and office calls to drive account independence. +… more
    Hologic (11/01/25)
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