• Intake Coordinator-RN Lhtc/ Evenings

    Villa of Hope (Rochester, NY)
    …coordinator, providers, director of LHTC and administrative team, including billing and utilization review . + Triages potential admissions and when needed ... JOB TITLE: Intake Coordinator- RN/ Evening DEPARTMENT/PROGRAM: Medical Services SUPERVISOR: Nurse Manager/Health Coordinator PAY GRADE: 82 FLSA STATUS: NON EXEMPT… more
    Villa of Hope (08/09/25)
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  • Director, Care Coordination

    Northwell Health (Mount Kisco, NY)
    …Case Management and Social Work Services team. Develops processes to monitor utilization review inclusive of length of stay (LOS) and resource reduction ... facility best practices and makes recommendations for process improvement. Oversees resource utilization for the hospital and provides specific data analysis on … more
    Northwell Health (08/21/25)
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  • RN Case Manager

    Stony Brook University (Stony Brook, NY)
    … Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...assigned. Identifies, follows and documents Avoidable delays in Care Management Program. Reviews and documents on patients who were… more
    Stony Brook University (07/16/25)
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  • Treatment Team Leader Developmental Disabilities…

    New York State Civil Service (Poughkeepsie, NY)
    …2, Teacher 4 (and all parenthetics), Training Specialist 1 (Nursing), and Utilization Review Coordinator. Additional Comments * Please note that starting ... direct care staff and clinicians including the psychologist, dietitian, nurse , and other titles. * Monitors all budgetary concerns...maintenance of records. In addition, * Is responsible for management of incidents and abuse reporting, as well as… more
    New York State Civil Service (08/21/25)
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  • Clinical Denials & Appeals Specialist

    Northwell Health (Melville, NY)
    Review standard and regulations. Performs concurrent and retrospective utilization management using evidenced-based medical necessity criteria; conducts ... date. Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications...certifications as needed. Preferred Skills 3-5 years experience in Utilization Review , Case Management , and… more
    Northwell Health (08/20/25)
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  • Director of Care Coordination (RN)

    Catholic Health Services (West Islip, NY)
    …Staff. Ensures compliance with Hospital Conditions of Participation. Implements care management programs, including utilization review , intake and ... a hospital care management leadership role is required. Experience in utilization management , working with managed care organizations, and discharge planning… more
    Catholic Health Services (07/18/25)
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  • Patient Care Coordinator

    Kaleida Health (Williamsville, NY)
    …care Nursing Experience required. 2 years of experience in any combination of case management , home care and utilization review preferred. Knowledge of and ... with members of the interdisciplinary team to coordinate care, facilitate utilization and resource management and discharge planning functions, working… more
    Kaleida Health (06/19/25)
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  • Sr VP Medical Director (Hourly)

    Sedgwick (Albany, NY)
    …(10) of related experience required to include one (1) to three (3) years utilization review experience and three (3) years clinical quality control. **Skills & ... the following: + Conducting reviews on cases where the nurse is seeking treatment plan clarification, claim denial, disability...+ Knowledge of ADAA and FMLA + Knowledge of utilization review procedures + Knowledge of clinical… more
    Sedgwick (08/22/25)
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  • RN, Quality Assurance

    University of Rochester (Rochester, NY)
    …Serves as the primary internal contact for national and state registry data management questions, issues or concerns, but not limited to clinical data collection, ... validation, delivery, reconciliation, and data management activity timeliness. Concurrently and retrospectively reviews medical records and data to identify patient… more
    University of Rochester (08/07/25)
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  • Treatment Team Leader Developmental Disabilities…

    New York State Civil Service (Wassaic, NY)
    …2, Teacher 4 (and all parenthetics), Training Specialist 1 (Nursing), and Utilization Review Coordinator. Additional Comments * Please note that starting ... development * Participate on DDSOO committees as assigned* Incident management responsibilities including complete MNO injury and Justice Center Investigations… more
    New York State Civil Service (08/21/25)
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