• Clinical Appeals Nurse (RN)

    Molina Healthcare (Albany, NY)
    …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
    Molina Healthcare (08/15/25)
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  • Registered Nurse

    WMCHealth (Suffern, NY)
    Registered Nurse Company: Good Samaritan Hospital City/State: Suffern, NY Category: Nursing/Nursing Management Department: Labor & Delivery Union: YES Union ... Now External Applicant link Internal Applicant link Job Details: The Registered Nurse provides professional nursing care to patients within the Labor & Delivery… more
    WMCHealth (07/25/25)
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  • Care Review Clinician, Prior Auth (RN) Pega Float…

    Molina Healthcare (NY)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... Experience using PEGA **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… more
    Molina Healthcare (07/12/25)
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  • Registered Nurse I, Acute Care - Medical…

    Bassett Healthcare (Delhi, NY)
    …enjoy the best quality of life possible. What you'll do The Registered Professional Nurse I, Acute Care is accountable for the delivery of safe patient care ... and job description is only appropriate for a new nurse in the first year of practice, as support...feedback and managerial observation. Demonstrates consideration of safety, effective utilization of equipment and materials, and cost in managing… more
    Bassett Healthcare (08/13/25)
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  • Nurse Practitioner Mobile - Part Time

    Project Renewal, Inc. (New York, NY)
    …programs + Participates in the development and implementation of quality assurance management and utilization review + Participates in interdisciplinary meetings ... Title: Primary Care Nurse Practitioner - Part Time Program: Healthcare Department...$87,000 depending on experience Position Overview: The Primary Care Nurse Practitioner working in Mobile Health is responsible for… more
    Project Renewal, Inc. (08/08/25)
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  • Assistant Nurse Manager

    Rochester Regional Health (Rochester, NY)
    Job Title: Assistant Nurse ManagerDepartment: Sands 600 (Oncology) Location: RGH Hours Per Week: 40 hoursSchedule: M-F Days SUMMARY:The Assistant Nurse Manager ... ANM is the main contact for a variety of nursing functions in support of management and staff. Serves as a resource for clinical expertise and mentoring / coaching… more
    Rochester Regional Health (07/24/25)
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  • Psychiatric Nurse Practitioner

    Wellpath (Valhalla, NY)
    …of care support. **How you make a difference** The Psychiatric Nurse Practitioner(Psych NP)follows established policies and procedures and state guidelines, ensuring ... through proper documentation. Theyprovidepsychiatric consultation, diagnostic, treatment, and medication management services to patients, including crisis intervention services. Overall,… more
    Wellpath (07/23/25)
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  • Nurse Case Manager

    Brighton Health Plan Solutions, LLC (New York, NY)
    …Case Management . * Determines appropriate care level and resource utilization for complex cases. * Facilitates discharge planning and evaluates alternative ... The Role Brighton Health Plan Solutions (BHPS) provides Case Management services to its clients. Cases are maintained by...services to its clients. Cases are maintained by the Nurse Case manager. The Nurse Case Manager… more
    Brighton Health Plan Solutions, LLC (07/18/25)
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  • Registered Nurse - Acute General Medicine

    Rochester Regional Health (Rochester, NY)
    Job Title: Registered Nurse - Acute General Medicine Department: Acute General Medicine (4800) Location: Rochester General Hospital Hours Per Week: Full-Time (36 ... Sign-On Bonus: Up to $15,000 SUMMARY: As a Registered Nurse (RN), you're the engine and the heart of...areas such as cardiac care with telemetry monitoring, diabetes management , renal disease and dialysis, pulmonary conditions, and the… more
    Rochester Regional Health (07/02/25)
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  • Registered Nurse

    WMCHealth (Suffern, NY)
    Registered Nurse Company: Good Samaritan Hospital City/State: Suffern, NY Category: Nursing/Nursing Management Department: Same Day Surgery - Medical Union: YES ... Now External Applicant link Internal Applicant link Job Details: The Registered Nurse provides direct nursing care by assessing patients' needs, performing physical… more
    WMCHealth (08/13/25)
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