• Clinical Review Clinician - Appeals

    Centene Corporation (New York, NY)
    …experience. Knowledge of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. RN or LPN Preferred ... million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization...- Licensed Vocational Nurse required or + RN - Registered Nurse -… more
    Centene Corporation (05/08/25)
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  • Care Facilitator- Per Diem- Canton-Potsdam…

    Rochester Regional Health (Rochester, NY)
    …LICENSES / CERTIFICATIONS: BLS - Basic Life Support - American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... Management Data base to support the clinical review process. + Concurrently monitors resources utilization ,...Certification/Licensure + Licensed in New York State as a Registered Nurse Required Years of Experience +… more
    Rochester Regional Health (04/26/25)
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  • Care Manager

    Rochester Regional Health (Rochester, NY)
    …LICENSES / CERTIFICATIONS: BLS - Basic Life Support - American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... per week Schedule: M-F Days 8am-430pm SUMMARY: As a Registered Nurse - Care Manager, your excellent...* 3 years of acute hospital care, Nursing, Case Management , or Utilization Management experience… more
    Rochester Regional Health (04/30/25)
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  • Behavioral Health UR Clinician

    Independent Health (Buffalo, NY)
    …licensed behavioral health professional (such as a LCSW, LMSW, LMHC, LPC, LMFT) or a Registered Nurse ( RN ) with active, unrestricted NYS license required. + ... that fosters growth, innovation and collaboration. **Overview** The Behavioral Health Utilization Review Clinician will primarily be responsible for managing… more
    Independent Health (05/15/25)
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  • Patient Management Supervisor

    Kaleida Health (Williamsville, NY)
    …Office Suite and Outlook. 2 years of experience In any combination of: case management , home care and utilization review preferred. Knowledge of and ... **Patient Management Supervisor** **Location:** Millard Fillmore Suburban **Location of...Nursing required. Bachelors or Masters in Social Work preferred. RN Licensure required. **Experience** **2 years of experience in… more
    Kaleida Health (05/03/25)
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  • Nurse Practitioner-Critical Care - Mount…

    Mount Sinai Health System (New York, NY)
    …Additional Detail** 1. Licensure: New York State License with current registration as a registered nurse . 2. State Certification: Certified by the New York State ... 6910 of the New York Education Law is a RN who has earned a separate certification as an...follows: a. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
    Mount Sinai Health System (05/12/25)
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  • Nurse Practitioner-Neurosurgery-Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …Additional Detail** 1. Licensure: New York State License with current registration as a registered nurse . 2. State Certification: Certified by the New York State ... 6910 of the New York Education Law is a RN who has earned a separate certification as an...follows: a. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
    Mount Sinai Health System (04/25/25)
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  • Nurse Practitioner - Cardiovascular…

    Mount Sinai Health System (New York, NY)
    …REQUIREMENTS** 1. Licensure: New York State License with current registration as a registered nurse . 2. State Certification: Certified by the New York State ... 6910 of the New York Education Law is a RN who has earned a separate certification as an...follows: 3. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
    Mount Sinai Health System (04/04/25)
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  • Clinical Reviewer, Nurse (Pain Mngt)

    Evolent (Albany, NY)
    …in Nursing (Must be a Registered Nurse ) + Experience as an RN in a Pain Management setting is preferred + Strong interpersonal and communication skills ... , you will be a key member of the utilization management team. We can offer you...Nurse , you will routinely interact with leadership and management staff, other CR's (Clinical Reviewers), providers, office staff… more
    Evolent (05/16/25)
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  • Case Manager- Case Management

    Arnot Health (Elmira, NY)
    …related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. ... nursing program with a current license as a registered nurse . BSN or Case Management...nursing in acute care hospital setting or two years utilization management in an acute care hospital… more
    Arnot Health (05/08/25)
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