• UM RN

    Centers Plan for Healthy Living (Queens, NY)
    …with the guidance and plans they need for healthy living. JOB SUMMARY: The Utilization Management nurse works within a multidisciplinary team to help ... their home to improve their quality of life. The Utilization Management nurse will assess...NYS RN license + Minimum 2 years utilization management experience + Strong written and… more
    Centers Plan for Healthy Living (04/15/25)
    - Related Jobs

  • Clinical Case Manager

    SUNY Upstate Medical University (Syracuse, NY)
    …(3) years acute care RN or acute care, transitional care, or chronic care RN / case management experience OR Associates degree in Nursing and five (5) ... years acute care RN or acute care, transitional care, or chronic care RN / case management experience required. *If Associate in Nursing, must be enrolled… more
    SUNY Upstate Medical University (04/16/25)
    - Related Jobs

  • Assistant Vice President

    Sedgwick (Albany, NY)
    …and client satisfaction; to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for ... business lines; and to provide expertise in client specific case management and utilization review...promote maximum performance. **QUALIFICATIONS** **Education & Licensing** Current unrestricted RN license in a state or territory of the… more
    Sedgwick (03/29/25)
    - Related Jobs

  • RN , Care Manager (Full-Time)

    Hudson Headwaters Health Network (Warrensburg, NY)
    …and other members of the care team for appropriate healthcare utilization , chronic disease (eg diabetes, hypertension) self- management skills, effective ... 40 hours per week. Monday-Friday 8am-4:30pm Position Summary The RN Care Manager is an integral part of the...+ Current BLS certification + Applied professional experience in case (care) management and/or social work preferred.… more
    Hudson Headwaters Health Network (04/30/25)
    - Related Jobs

  • Clinical Case Manager

    SUNY Upstate Medical University (Syracuse, NY)
    …(3) years acute care RN or acute care, transitional care, or chronic care RN / case management experience OR Associates degree in Nursing and five (5) ... utilization of services, and financial goals. The Clinical Case Manager oversees the discharge process for all patients... or acute care, transitional care, or chronic care RN / case management experience required. *If… more
    SUNY Upstate Medical University (02/25/25)
    - Related Jobs

  • Nurse Case Manager - Full Time, Days

    Nuvance Health (Poughkeepsie, NY)
    …of the Director, The Nurse Case Manager role provide clinically-based case management to support the delivery of effective and efficient patient care. ... Paces the case from physiological and economic perspectives. Has overall accountability...have current RN license. Preferred experience in Utilization Review/ Management .Company: Vassar Brothers Medical Center Org… more
    Nuvance Health (04/26/25)
    - Related Jobs

  • Clinical Care Manager ( RN ) -- CMO

    VNS Health (Manhattan, NY)
    …care management services using evidence-based practices to ensure effective utilization of benefits, services, and care is provided to the patients allowing ... for all members on his/her caseload. + Completes care management and disease specific assessments. + Makes timely telephonic...+ License and current registration to practice as a Registered Professional Nurse in NYS required or… more
    VNS Health (04/15/25)
    - Related Jobs

  • Manager, Grievance and Appeals, RN

    VNS Health (Manhattan, NY)
    …years' experience in a Grievance and Appeals or related area such as medical or utilization management in a Managed Care setting required + Experience in a ... Plans is seeking a dedicated Manager, Grievance and Appeals ( RN )to lead the daily operations of our grievance and...+ License and current registration to practice as a registered professional nurse in New York State… more
    VNS Health (03/05/25)
    - Related Jobs

  • Education Manager, RN (Health Plans)

    VNS Health (Manhattan, NY)
    …license and registration to practice as a Registered Professional Nurse CM certification (Certified Care Management ) preferred Education: Bachelor's Degree ... always at the cutting edge of healthcare excellence. Bring your experience in Utilization Management to develop new and modify existing curriculum and training… more
    VNS Health (03/05/25)
    - Related Jobs

  • Case Manager Supervisor

    Stony Brook University (Stony Brook, NY)
    …Qualifications:** + Master's Degree, + Certified RN , + CM Five years Case management experience + Recent tertiary care experience. + Working knowledge of ... standard of excellence. **Duties of a TH Staff Associate/Supervising Case Manager in the Care Management Department...staff performance including new staff orientation + Knowledge of Utilization Review and LOS + Review of high-risk complex… more
    Stony Brook University (04/15/25)
    - Related Jobs