• UM Behavioral Health Nurse

    Humana (Albany, NY)
    …timeframe **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) Compact license, with no disciplinary action ... and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and… more
    Humana (09/09/25)
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  • UM Case Manager - 100%

    Healthfirst (NY)
    …Occasional overtime as necessary + Additional duties as assigned **Minimum Qualifications:** RN , LPN, LMSW, LMHC,LMFT, LCSW, PT, OT, and/or ST license **Preferred ... Qualifications:** + Masters degree in a related discipline + Experience in managed care, case management, identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of Centers for… more
    Healthfirst (09/10/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (Syracuse, NY)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. To all… more
    Molina Healthcare (08/16/25)
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  • Care Review Clinician, Prior Auth ( RN

    Molina Healthcare (NY)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
    Molina Healthcare (07/12/25)
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  • RN - FT Nights - Emergency Department…

    Trinity Health (Troy, NY)
    …to meet those needs **What you will need:** + A current license to practice as a Registered Nurse in the State of New York + ASN required, BSN preferred from an ... on M/S units. Will work closely with Hospitalist and CM/ UM assigned to unit. Here at St. Peter's Health...that the plan of care is evaluated + The RN is directly accountable to the Nurse more
    Trinity Health (08/14/25)
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  • Care Review Clinician, PA ( RN

    Molina Healthcare (Albany, NY)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Previous… more
    Molina Healthcare (08/31/25)
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  • Case Manager, RN or Licensed Behavioral…

    Excellus BlueCross BlueShield (Dewitt, NY)
    …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist...Certification required + Broad understanding of multiple areas (ie UM and CM). At this level, incumbent is required… more
    Excellus BlueCross BlueShield (08/28/25)
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  • RN Case Manager

    Stony Brook University (Stony Brook, NY)
    …coverage as needed and other duties as required. **Qualifications** **Required** : Current NYS RN . A Bachelor's degree or a nurse working on their degree with ... RN Case Manager **Position Summary** At Stony Brook...their work and follow up with cases. **Preferred:** CM, UM , Quality, Coding, Risk or MCG Certification Working knowledge… more
    Stony Brook University (07/16/25)
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  • RN Supervisor for Obs Unit at Samaritan…

    Trinity Health (Troy, NY)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Nurse Supervisor for NEW Observation Unit at Samaritan Hospital** **Pavilion Building - 4T** ... **EXEMPT** **FT Days** If you are an experienced RN looking for a **_leadership_** position in the Observation/Clinical...M/S units. + Will work closely with Hospitalist and CM/ UM assigned to unit. **Functional Role (not inclusive of… more
    Trinity Health (08/15/25)
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  • Care Review Clinician, Inpatient Review…

    Molina Healthcare (Rochester, NY)
    …acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must ... Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional travel to other Molina offices or… more
    Molina Healthcare (08/31/25)
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