• Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …efforts to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ... position and also take into account information provided by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case /Care Management Position… more
    Helio Health Inc. (07/11/25)
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  • RN/ Case Manager -MSH- Case…

    Mount Sinai Health System (New York, NY)
    **Job Description** **RN/ Case Manager MSH Case ... utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... are not limited to: a Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using… more
    Mount Sinai Health System (07/15/25)
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  • RN/ Case Manager -Inpatient-Mount…

    Mount Sinai Health System (New York, NY)
    …in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5 years? ... **Job Description** **RN/ Case Manager Inpatient Mount Sinai West...1. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management… more
    Mount Sinai Health System (07/08/25)
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  • Utilization Review Manager

    Phoenix House (Wainscott, NY)
    ** Utilization Review Manager ** **Job Details** **Job Location** East Hampton Residential - Wainscott, NY **Position Type** Full Time **Education Level** Graduate ... Morning **Job Category** Nonprofit - Social Services **Description** **SUMMARY** The Utilization Review (UR) Manager coordinates commercial, and Medicaid Managed… more
    Phoenix House (06/25/25)
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  • Case Manager - Case…

    Arnot Health (Elmira, NY)
    …processes related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge ... Job Description MAIN FUNCTION: The Case Manager coordinates, negotiates, procures services... case managers. f. The Case Manager tracks and trends LOS, resource utilization ,… more
    Arnot Health (05/08/25)
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  • Pharmacist, Utilization Management (UM)

    Molina Healthcare (NY)
    …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... and quality initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and cost control issues… more
    Molina Healthcare (07/19/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    Position Summary: The Acute Case Manager utilizes industry accepted processes for achieving optimal patient, clinical, and operational outcomes timely, ... coordinated, and in cost effective manners. The Acute Case Manager has the responsibility, accountability, and...in an acute care setting with strong care management, utilization review, and payer knowledge. A Case … more
    Guthrie (05/13/25)
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  • Case Manager , RN- Rehab…

    Northwell Health (Staten Island, NY)
    …delays and resolves issues with appropriate departments. + Identifies appropriate utilization of Social Work Services and makes referrals when appropriate. + ... + Serves as a resource to the health care team regarding quality, utilization of clinical resources, payer, and reimbursement issues. + Works with on-site screeners… more
    Northwell Health (07/08/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …patient's required needs and covered services. Support services provided by the Case Manager include, but are not limited to, utilization review, case ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for ...inpatient experience in a hospital environment preferred. + Previous case management, utilization review, and discharge planning… more
    Ellis Medicine (06/12/25)
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  • Case Manager , RN or Licensed…

    Excellus BlueCross BlueShield (Rochester, NY)
    …auditor within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and ... Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for… more
    Excellus BlueCross BlueShield (06/27/25)
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