• 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 (09/19/25)
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  • Clinical Program Manager - Clinical Command Center…

    Mount Sinai Health System (New York, NY)
    …The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse , Physician Assistant, or Nurse Practitioner, who manages the 24 ... and supporting patient-centered care. **Qualifications** Must be a Licensed Registered Nurse , Physician Assistant or Nurse Practitioner Registered Nurse more
    Mount Sinai Health System (11/08/25)
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  • RN/Case Manager (Inpatient)-Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …are not limited to: 1. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using ... (CM) will be responsible for all aspects of case management for an assigned group of inpatients to determine...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
    Mount Sinai Health System (11/05/25)
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  • RN Clinical Manager

    CenterWell (Westbury, NY)
    …driver's license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home health, ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts… more
    CenterWell (09/30/25)
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  • Director of Care Coordination (RN)

    Catholic Health Services (West Islip, NY)
    …hospital care management leadership role is required. + Experience in utilization management , working with managed care organizations, and discharge planning ... : + Works collaboratively with, but not limited to, Medical Staff, Quality/Risk Management , CH Utilization and Central Appeals, Managed Care and Revenue Cycle… more
    Catholic Health Services (10/16/25)
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  • Appeals Manager

    BronxCare Health System (Bronx, NY)
    …assist the department's leadership develop strategies for denial prevention, improved utilization management , documentation of medical necessity and identify ... of stay, avoidable day and barriers to discharge processes pertaining to utilization management . - Liaisons and coordinates with other hospital departments… more
    BronxCare Health System (11/15/25)
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  • Intake Coordinator-RN Lhtc/ Evenings

    Villa of Hope (Rochester, NY)
    …JOB TITLE: Intake Coordinator- RN/ Evening DEPARTMENT/PROGRAM: Medical Services SUPERVISOR: Nurse Manager/Health Coordinator PAY GRADE: 82 FLSA STATUS: NON EXEMPT ... JOB SUMMARY: Under the general direction of the Nurse Manager, the Intake Coordinator-RN is a Registered ...director of LHTC and administrative team, including billing and utilization review. + Triages potential admissions and when needed… more
    Villa of Hope (11/22/25)
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  • Perioperative Operational Analyst - Full Time…

    Mohawk Valley Health System (Utica, NY)
    …Services. + Familiarizes self with each unit's activities and benchmarks through staffing utilization reports, and dialogues with charge nurse , nurse manager ... graphs and narrative information using departmental data. + Reviews performance and management indicator reports. + Maintains staff utilization policies and… more
    Mohawk Valley Health System (11/12/25)
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  • Healthcare Services Auditor (RN) - Clinical…

    Molina Healthcare (Syracuse, NY)
    …outcomes, findings and recommended corrective actions. + Performs audits in utilization management , care management , member assessment, behavioral ... care experience, with at least 1 year experience in utilization management , care management , and/or...or equivalent combination of relevant education and experience.* Registered Nurse (RN). License must be active and restricted in… more
    Molina Healthcare (12/09/25)
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  • Medical Director - Medical Oncology

    Elevance Health (New York, NY)
    **Clinical Operations Medical Director** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
    Elevance Health (12/04/25)
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