• Sr Director Quality Management & Regulatory…

    Mohawk Valley Health System (Utica, NY)
    …+ 8 years of clinical experience. Previous or current experience working in Quality Management / Utilization Management field. + 5 years of management ... Sr Director Quality Management & Regulatory Affairs - Full Time -...health related field Licensure/Certification Requirements REQUIRED: + Licensed NYS Registered Nurse . + CPHQ certification. Disclaimer Qualified… more
    Mohawk Valley Health System (07/09/25)
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  • Director of Care Coordination

    Catholic Health Services (West Islip, NY)
    …(BSN) degree required. Master of Science degree strongly preferred. Licensure: New York Registered Nurse ( RN ) License & Registration. Certification: Care ... compliance with Hospital Conditions of Participation. Implements care management programs, including utilization review, intake and discharge planning.… more
    Catholic Health Services (07/18/25)
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  • MDS Coordinator

    Elderwood (Hamburg, NY)
    Salary Up to $49.50 / Hour Overview Elderwood at Hamburg is seeking a Registered Nurse ( RN ) to join our clinical team as a MDS Nurse . Position Overview: ... + An MDS (Minimum Data Set) nurse , or nurse assessment coordinator, collects and...State requirements, and facility policies. + Actively participate in utilization management processes, including PDPM and state… more
    Elderwood (08/02/25)
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  • Assistant Nurse Manager

    Rochester Regional Health (Rochester, NY)
    …other team members as needed.* Perform other duties as assigned. REQUIRED QUALIFICATIONS: + Registered Nurse license in New York State + Associate of Science in ... for a variety of nursing functions in support of management and staff. Serves as a resource for clinical...QUALIFICATIONS: + 1 - 3 years' experience as a Registered Nurse + Certification in area of… more
    Rochester Regional Health (08/08/25)
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  • Medical Director, Children's Services (SafetyNet…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …calls in timely manner and provides support for the Case Management (CM) and Registered Nurse ( RN ) reviewers and manages the denial process. + Leads ... management rounds. + Provision of clinical oversight and leadership to Utilization Management /Case Management (UM/CM) staff working with the children's… more
    Excellus BlueCross BlueShield (08/09/25)
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  • Ambulatory Care Manager

    WMCHealth (West Nyack, NY)
    …care management standards and community resources highly preferred. Education: Registered Nurse , Bachelor's degree preferred Licenses / Certifications : ... Charity Medical Group City/State: West Nyack, NY Category: Nursing/Nursing Management Department: Admin - Orange County Union: NO Position:...Current license as a Registered Nurse is required. About Us: Bon… more
    WMCHealth (07/24/25)
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  • Care Delivery Manager

    CenterLight Health System (Ridgewood, NY)
    …unrestricted license and registration in New York State required as a Registered Nurse . Language: Bilingual preferred. Physical Requirements Individuals must be ... care. Serve the organization as a member of the management team, working alongside all departments and employees to...Delivery reports. + Participates and represents the Community Health Nurse (CHN) in IDT meetings, when required. + Balance… more
    CenterLight Health System (08/08/25)
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  • Program Manager, HCS

    Molina Healthcare (Buffalo, NY)
    …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of ...years in one or more of the following areas: utilization management , case management , care… more
    Molina Healthcare (08/02/25)
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  • Assistant Nurse Manager

    Rochester Regional Health (Rochester, NY)
    …evaluations for team members; attend all required educational programs. REQUIRED QUALIFICATIONS: + Registered Nurse license in New York State. + BLS through ... for a variety of nursing functions in support of management and staff. Serves as a resource for clinical...QUALIFICATIONS: + 1 - 3 years' experience as a Registered Nurse + Certification in area of… more
    Rochester Regional Health (07/24/25)
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  • Assistant Nurse Manager

    Rochester Regional Health (Rochester, NY)
    …of Science in Nursing (BSN) preferred. * 1 - 3 years' experience as a Registered Nurse is highly preferred. * Demonstrated leadership qualities and behaviors. * ... for a variety of nursing functions in support of management and staff. Serves as a resource for clinical...(BSN) preferred. - For Dialysis: BSN preferred Required Licensure/Certification Skills:* Registered Nurse license in New York State.… more
    Rochester Regional Health (05/21/25)
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