• Utilization Management - Registered…

    Crouse Hospital (Syracuse, NY)
    …education and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage data and ... to the utilization of services. Pay Range: $80,000.00 / year + Utilization Management RNs are eligible for up to a $10,000 Sign-On Bonus! Schedule: Full… more
    Crouse Hospital (09/25/25)
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  • RN, Manager, Utilization Management

    Humana (Albany, NY)
    …a part of our caring community and help us put health first** The Manager, Utilization Management Nursing (LTSS Utilization Management Leader) utilizes ... communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines and… more
    Humana (09/28/25)
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  • Senior Analyst, Utilization

    Molina Healthcare (Syracuse, NY)
    **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The **Senior Analyst, Utilization Management ** plays a critical role in supporting clinical and ... business needs into technical solutions. This role works closely with clinicians, utilization management teams, and business stakeholders to gather requirements… more
    Molina Healthcare (09/25/25)
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  • Utilization Management Nurse…

    CVS Health (Albany, NY)
    …Must have active current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include ... in previous roles. **Preferred Qualifications** Managed Care experience and/or Utilization Management experience preferred **Education** Associates Degree in… more
    CVS Health (09/27/25)
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  • RN Utilization Management

    Trinity Health (Albany, NY)
    …these differences often lead to innovative solutions. **Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme Days** If ... to accommodate all schedules **What you will do:** + Perform utilization management , both concurrent and retroactive for inpatient and outpatient services in… more
    Trinity Health (09/30/25)
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  • Utilization Management Nurse

    Humana (Albany, NY)
    …part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
    Humana (09/26/25)
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  • Utilization Management

    Elevance Health (Latham, NY)
    ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for managing incoming calls,… more
    Elevance Health (09/25/25)
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  • Clinical Learning Facilitator - Utilization

    Molina Healthcare (Buffalo, NY)
    …state board licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/behavioral health settings. + One year of ... or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in Health Care… more
    Molina Healthcare (09/17/25)
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  • Utilization Management Strategy Lead

    Humana (Albany, NY)
    …into concrete roadmaps that will generate tangible value to all stakeholders. Within Utilization Management , our goal is to enable members to receive the ... math or business related + Minimum 2 years of experience with a leading management consulting firm + Strong analytical & strategic skillset + Ability to interpret… more
    Humana (09/23/25)
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  • RN Utilization Review - System Care…

    Guthrie (Binghamton, NY)
    …necessary. Oversees and coordinates compliance to federally mandated and third party payer utilization management rules and regulations The pay range for this ... Provides health care services regarding admissions, case management , discharge planning and utilization review. Responsibilites: Reviews admissions and service… more
    Guthrie (07/05/25)
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