• Care Facilitator- Canton-Potsdam Hospital, Potsdam

    Rochester Regional Health (Rochester, NY)
    …New York State as a Registered Nurse PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience + Bachelor's Degree EDUCATION: ... efficient utilization of resources. Carries out activities related to utilization management , discharge planning, care coordination and referral to other… more
    Rochester Regional Health (01/06/26)
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  • Administrator of Admissions, Outreach & Intake

    Calvary Hospital (Bronx, NY)
    …pertinent data. 8. Knowledge of and experience in Quality Assessment and Improvement, Utilization Review. 9. Ability to develop management systems to track data ... to facilitate reimbursement for services provided by the Hospital. Oversees the appeals process for those cases for which reimbursement has been denied. Conducts… more
    Calvary Hospital (11/19/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Albany, NY)
    …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is...set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. JOB DESCRIPTION Job… more
    Molina Healthcare (12/24/25)
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