• UR Coordinator

    Arms Acres (Carmel, NY)
    …enhance the services we provide. The UR Coordinator assists in the overall utilization management process to ensure that services and programs meet accepted ... eligible and/or have at least three years' experience in case management , utilization management or chemical dependency. PHYSICAL DEMANDS: The physical… more
    Arms Acres (09/23/25)
    - Related Jobs
  • Case Manager - RN

    Calvary Hospital (Bronx, NY)
    …unencumbered NYS licensure. + Five (5) or more years experience in either Utilization Management , Quality Assessment and Improvement, Risk Management , and/or ... Spending, Transit Check. + Free On-Site Parking Requirements Participates in the Utilization Review, Discharge Planning, Risk Management , and Quality Assessment… more
    Calvary Hospital (09/11/25)
    - Related Jobs
  • Care Manager - Readmission Specialist

    Stony Brook University (Stony Brook, NY)
    …telephonically post-discharge and assist with barriers to care * Prior experience with Care Management or Utilization Management * Understand levels of care ... is provided to the patients. * Documents the case management plans such as clinical needs, barriers, utilization... management plans such as clinical needs, barriers, utilization of resources via assessments and/or progress notes. *… more
    Stony Brook University (07/15/25)
    - Related Jobs
  • Clinical UM Nurse 2

    CenterWell (Albany, NY)
    …a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... in a high volume and fast paced environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a related field + Health… more
    CenterWell (09/26/25)
    - Related Jobs
  • Nurse Case Manager Per Diem

    Nuvance Health (Rhinebeck, NY)
    …case from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within ... of the Director, The Nurse Case Manager role provide clinically-based case management to support the delivery of effective and efficient patient care. Paces… more
    Nuvance Health (09/21/25)
    - Related Jobs
  • LVN Delegation Oversight Nurse Remote

    Molina Healthcare (Rochester, NY)
    …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... proficient, self-directed, autonomous and experience working from home. Care Management & Waiver Service Auditing experience is highly preferred. Work… more
    Molina Healthcare (09/20/25)
    - Related Jobs
  • Provider Engagement Account Executive

    Centene Corporation (Queens, NY)
    …of managed care or medical group experience, provider relations, quality improvement, utilization management , or clinical operations. Project management ... care to our members. Participate in the development of network management strategies. Creates strategic initiatives for performance improvement. + Conducts regular… more
    Centene Corporation (09/10/25)
    - Related Jobs
  • Care Manager

    Catholic Health Services (Smithtown, NY)
    …patients across the acute care continuum. + Performs required activities for utilization management , PRI assessment and completion, transition planning, and ... clinical medical/surgical or specialty experience required. + 2-3 years' Utilization Management , Performance Improvement, Transition Planning and/or Care… more
    Catholic Health Services (08/22/25)
    - Related Jobs
  • Associate Director, Performance Analytics

    Evolent (Albany, NY)
    …billing and various sites of care/service + Familiarity with value-based care and utilization management + Understanding of data systems and the critical ... member-centric products. This role plays a critical part in both **Medical Cost Management ** and **Product Management ** , leveraging advanced analytics to solve… more
    Evolent (07/15/25)
    - Related Jobs
  • SVP, Oncology

    Evolent (Albany, NY)
    …Oncology is a key clinical executive responsible for leading oncology-related utilization management , quality improvement, and clinical operations across ... cost of oncology care + Lead the development of strategies for care management , utilization mitigation, and value-based incentive programs **Desired Skill Set**… more
    Evolent (09/28/25)
    - Related Jobs