• Registered Nurse ( RN )…

    Rochester Regional Health (Rochester, NY)
    Job Title: Registered Nurse IDepartment: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time)Schedule: Monday ... Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act...- Basic Life Support - American Heart Association (AHA), RN - Registered Nurse -… more
    Rochester Regional Health (08/02/25)
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  • Supervisor, Care Review ( RN )

    Molina Healthcare (Syracuse, NY)
    …and monitoring clinical and non-clinical team activities to facilitate integrated, proactive utilization management , ensuring compliance with regulatory and ... and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review, and/or other utilization management more
    Molina Healthcare (07/27/25)
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  • Registered Nurse ( RN )…

    Rochester Regional Health (Rochester, NY)
    Job Title: Registered Nurse ( RN ) -...an 18-bed unit specializing in cardiac care and stroke management . With a 1:4 nurse -to-patient ratio, we ... Full Time (36 hours)Schedule: Evening/Night (6pm-6am), rotating weekends and holidays SUMMARY:As a Registered Nurse ( RN ), you're the engine and the heart… more
    Rochester Regional Health (07/25/25)
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  • Registered Nurse ( RN

    Rochester Regional Health (Rochester, NY)
    …Schedule: Straight Shift- Nights. Every other weekend/holidays. Sign-On Bonus: $15,000 SUMMARY: As a Registered Nurse ( RN ), you're the engine and the heart ... on 3800 provide direct bedside care, patient education, pain management , post-op recovery support, and discharge planning. The unit...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
    Rochester Regional Health (07/25/25)
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  • Appeals Registered Nurse

    Evolent (Albany, NY)
    …and as an RN - **Required** + Minimum of 5 years in Utilization Management , health care Appeals, compliance and/or grievances/complaints in a quality ... appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and...part of the application process. This is collected for compliance and security purposes and only reviewed if an… more
    Evolent (08/08/25)
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  • Care Manager ( Registered Nurse

    Catholic Health Services (Port Jefferson, NY)
    … 3+ Years acute care clinical RN experience required Prior RN experience in Utilization Management , Performance Improvement, Transition Planning ... across the acute care continuum. Perform required activities for utilization management , PRI assessment and completion, transition...in a BSN program may apply Licensure: New York Registered Nurse ( RN ) License &… more
    Catholic Health Services (06/30/25)
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  • Registered Nurse ( RN )

    Oneonta Job Corps (Oneonta, NY)
    …Microsoft Suite (Word, Excel, Outlook, PowerPoint.) Educational Requirements: + State Licensed Registered Nurse . + Three years' experience as a practicing ... in nurses' on-call rotation. + Function as a staff nurse as needed. + Collect data and maintain wellness...as needed. + Collect data and maintain wellness monthly Utilization Reports. + Plan, organize, and control the use… more
    Oneonta Job Corps (06/13/25)
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  • Registered Nurse ( RN ) Case…

    Northwell Health (Riverhead, NY)
    …Nursing, required. + Current license to practice as a Registered Professional Nurse in New York State. + Case Management Certification, preferred. + Minimum ... another level of care according to regulatory standards. + * Performs concurrent utilization management + Conducts chart review for appropriateness of admission… more
    Northwell Health (07/25/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Jamaica, NY)
    …appropriate training according to FMS policy, including training to ensure ongoing compliance with all FMS risk management initiatives. + Provides opportunities ... vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure… more
    Fresenius Medical Center (07/17/25)
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  • Dialysis Charge Registered Nurse

    Fresenius Medical Center (Schenectady, NY)
    …+ Assists with implementing appropriate training according to policy; ensure ongoing compliance with all risk management initiatives. + Responsible for ... staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and… more
    Fresenius Medical Center (06/28/25)
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