• Behavioral Health Care Manager II

    Elevance Health (Latham, NY)
    …(ABA) services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of ... and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to… more
    Elevance Health (07/02/25)
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  • RN -Ambulatory - Urogynecology Nurse

    Albany Medical Center (Albany, NY)
    …department. + Facilitates the utilization of resources to meet patient outcomes ( case management ). + Analyzes patient care needs and utilizes a systematic ... States of America) Salary Range: $60,028.00 - $99,023.00 Urogynecology Nurse ( RN ) Division of Urogynecology within the...Registered Nursing program is required + NYS current RN licensure to practice professional nursing is required +… more
    Albany Medical Center (06/29/25)
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  • Care Manager RN - (Remote)

    Highmark Health (Albany, NY)
    …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... , identification of opportunities for referral to a Health Coach/ case management , and identification and resolution of...clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS**… more
    Highmark Health (07/12/25)
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  • RN - Cardiothoracic Surgery Office

    Albany Medical Center (Albany, NY)
    …WIC + Facilitates the utilization of resources to meet patient outcomes ( case management ). + Writes letters of medical necessity as indicated + Participates ... required. Under the supervision of the Nursing Supervisor and Nurse Manager, the Ambulatory Care RN provides...following. Other related duties may be assigned: Support for Self- Management + Enhances health literacy + Performs a baseline… more
    Albany Medical Center (06/19/25)
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  • Care Delivery Manager RN

    FlexStaff (White Plains, NY)
    …healthcare experience. + NYSED-approved infection control coursework (8+ contact hours). + Case Management Certification recommended within two years. + 2+ years ... **Req Number** 158644 Care Delivery Manager RN White Plains, NY Schedule: M-F, 8:30am to...care services (nursing homes, rehab, etc.). + Monitor care management effectiveness, utilization , and adjust plans as… more
    FlexStaff (05/16/25)
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  • 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 (06/29/25)
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  • 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 (05/27/25)
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  • 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)
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  • Medical Claim Review Nurse ( RN )

    Molina Healthcare (Albany, NY)
    …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (07/12/25)
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  • 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 (05/30/25)
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