• MDS Coordinator RN

    Glengariff Rehabilitation and Healthcare Center (Glen Cove, NY)
    …trends on a monthly basis + Responsible for timely and accurate completion of Utilization Review and Triple Check + Serves on, participates in, and attends ... MDS Coordinator RN The Glengariff Healthcare Center is looking for...by their supervisor and Administrator MDS Coordinator Qualifications: + Registered Nurse with current, active license in… more
    Glengariff Rehabilitation and Healthcare Center (09/25/25)
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  • RN Unit Manager - Taylor Health

    Arnot Health (Bath, NY)
    …of all duties that may be assigned. EDUCATION: Current New York State Registered Nurse Licensure. BSN preferred. Certification in nursing specialty desirable. ... attends weekly care conference meetings, and weekly Medicare A review with care team and therapies. + Demonstrates effective...of the Long Term Care Department. + Ensures the utilization of the nursing process in maintaining quality of… more
    Arnot Health (07/28/25)
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  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    …Auth/Denial Management meetings EDUCATION: RN required. EXPERIENCE: NYS licensed Registered Nurse required. Bachelor's in nursing preferred. Must have ... for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and...proficient writing skills.Experience in Utilization Review and InterQual required. CARDIOPULMONARY RESUSCITATION… more
    Arnot Health (08/08/25)
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  • RN Clinical Appeals Nurse

    Molina Healthcare (Yonkers, NY)
    …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
    Molina Healthcare (09/26/25)
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  • Case Manager

    Garnet Health (Harris, NY)
    …of care from the hospital to home setting. Responsible for discharge planning, utilization review , team conferences and unit based rounds. At Garnet Health, ... to make your career home with us as a Case Manager on our Case Management team...negotiated contracts, budget and internal equity) Qualifications Minimum Education: Registered Nurse with New York State Licensure… more
    Garnet Health (09/27/25)
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  • Nurse Case Manager - FT Days

    Nuvance Health (Poughkeepsie, NY)
    …Must have Associate's Degree in Nursing, BSN preferred. Must have current RN license. *Preferred Experience: * Utilization Review /Management.Company: Vassar ... Summary - Discharge Planning primarily Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to… more
    Nuvance Health (09/28/25)
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  • Case Manager Supervisor

    Stony Brook University (Stony Brook, NY)
    …use of resources. + Oversee staff performance including new staff orientation + Knowledge of Utilization Review and LOS + Review of high-risk complex cases. ... as needed. **Preferred Qualifications:** + Master's Degree, + Certified RN , + CM Five years Case management...or for a maximum of 90 days. An initial review of all applicants will occur two weeks from… more
    Stony Brook University (09/16/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Latham, NY)
    **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
    Elevance Health (09/11/25)
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  • Care Facilitator- Per Diem- Canton-Potsdam…

    Rochester Regional Health (Rochester, NY)
    …Support - American Heart Association (AHA)American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education ... the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization ,...required + Licensed in New York State as a Registered Nurse + For hires after 10/28/2024,… more
    Rochester Regional Health (07/25/25)
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  • Discharge Planner

    Ellis Medicine (Schenectady, NY)
    …Workers (SW). The Discharge Planner's primary function is to work with the Social Worker, Nurse Case Manager, or Utilization Management Nurse to ... utilization management activities under the direction of a registered nurse and/or social worker. Responsibilities include...+ Assists Utilization Management with initial clinical review requests as needed. + Notifies Case more
    Ellis Medicine (08/28/25)
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