• Clinical Manager - Integrated Care Perm / Brooklyn…

    FlexStaff (New York, NY)
    …experience in care/case management , disease management , population health management , utilization review , quality assurance, or discharge planning ... systems License: Current active and unrestricted license in NYS as a Registered Nurse , required. Additional Requirements: Be legally authorized (for example,… more
    FlexStaff (04/18/25)
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  • RN - HIV Medicine Practice

    Albany Medical Center (Albany, NY)
    …Aids Program Work Shift: Day (United States of America) Salary Range: $60,028.00 - $99,023.00 Registered Nurse ( RN ) - Part Time HIV Medicine Clinic - Albany, ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...program is required * Current NYS license as a Registered Nurse is required * Minimum of… more
    Albany Medical Center (02/21/25)
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  • Intake Coordinator- RN Lhtc/ Evenings

    Villa of Hope (Rochester, NY)
    …JOB SUMMARY: Under the general direction of the Nurse Manager, the Intake Coordinator- RN is a Registered Nurse who will assist in supervising Clinical ... director of LHTC and administrative team, including billing and utilization review . + Triages potential admissions and...or leaving against medical advice. MINIMUM QUALIFICATIONS: + NYS Registered Nurse license + Bachelor degree preferred… more
    Villa of Hope (05/03/25)
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  • RN Case Manager - Case Management…

    Guthrie (Corning, NY)
    …or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or ... understanding of the regulatory requirements relative to the case management process. Certified to complete Patient Review ...of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who… more
    Guthrie (03/13/25)
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  • Director of Care Management and Nursing…

    Catholic Health Services (Smithtown, NY)
    …Staff. Ensure compliance with Hospital Conditions of Participation. Implement case management programs, including utilization review , intake or ... management leadership role is required Experience in utilization management , working with managed care organizations,...Master of Science degree strongly preferred Licensure: New York Registered Nurse ( RN ) License &… more
    Catholic Health Services (05/07/25)
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  • RN Uniform System Assessor field travel…

    Molina Healthcare (Buffalo, NY)
    …* UAS experience * Experience conducting home visits Required Licensure or Certification: * Registered Nurse ( RN ) State Specific Requirements: * Must reside ... for Medicaid and Medicare. We are looking for a RN candidate with a Uniform System Assessor (USA) or...medical equipment (DME). * Experience in utilization review , concurrent review and/or risk management… more
    Molina Healthcare (05/20/25)
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  • Consultant, Nurse Disability

    Lincoln Financial (Albany, NY)
    …Care, Orthopedics, Coronary Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like ... will provide coaching and guidance to claims regarding medical management **What you'll be doing** * Evaluate medical information...looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license… more
    Lincoln Financial (04/30/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Clifton Park, NY)
    …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home health ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...(NY state requirement) + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (05/20/25)
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  • CHS Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …queries from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, ... care to MCC in response to physician order, or review of updated clinical information Acts as a resource...current with industry standards and business objectives related to Utilization and Care Management as appropriate. Sound… more
    Catholic Health Services (03/19/25)
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  • RN /Case Manager-MSH-Case Management…

    Mount Sinai Health System (New York, NY)
    …to: a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using standardized ... **Job Description** ** RN /Case Manager MSH Case Management FT...Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or… more
    Mount Sinai Health System (04/15/25)
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