• RN Case Manager PC/FM

    Highland Hospital (Rochester, NY)
    …Manager, the RN Care Manager's central role integrates and coordinates access and utilization management , proactive patient management , care facilitation and ... experience. Ambulatory care experience in community health, care management , disease management , quality improvement and/or ...of health care technology. Familiarity with state law on nursing care, nurse practice guidelines, and clinical… more
    Highland Hospital (07/25/25)
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  • Case Manager at St Peters Hospital - All Shifts…

    Trinity Health (Albany, NY)
    …experience in acute setting **Preferred requirements:** + 1+ year of experience in case management or utilization management + Case Management ... Engage the patient and care team in the joint management of key patient outcomes such as management...valid NYS RN license + Bachelor of Science in nursing , or willingness to purse defined plan for matriculation… more
    Trinity Health (07/18/25)
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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 ... all telephone communications in accordance with department procedures using Care Management and other resources, escalates issues related to business associate… more
    BronxCare Health System (06/21/25)
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  • LPN - MDS Coordinator

    Elderwood (Liverpool, NY)
    …Federal and State requirements, and facility policies. + Actively participate in utilization management processes, including PDPM and state case mix process. ... Overview Elderwood at Liverpool is seeking a Licensed Professional Nurse to join our clinical team as a LPN...Elderwood at Liverpool: + Nationally recognized for quality skilled nursing care, Elderwood at Liverpool is located in a… more
    Elderwood (07/25/25)
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  • Staff Nurse (RN)

    UHS (Norwich, NY)
    …Health Services policy + Shares responsibility for productivity and effective resource utilization including staffing, time management , supplies, and services + ... Hospital is seeking a compassionate and skilled Staff Registered Nurse (RN) or Graduate Nurse (GN) dedicated...Join us to make a meaningful impact where your nursing expertise supports not only individual health but also… more
    UHS (06/27/25)
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  • Case Manager, Medicaid Long Term Support Program

    MVP Health Care (Tarrytown, NY)
    …every interaction **Your key responsibilities:** + Utilize the essentials of an integrated utilization management and case management model that includes ... bring:** + Current New York State Licensure as a Registered Nurse required. + Certification in Case Management required within 24 months after hire. + At least 3… more
    MVP Health Care (08/13/25)
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  • RN Case Manager (Hospital)

    Highland Hospital (Rochester, NY)
    …planning to achieve timely and safe discharge and/or to coordinate access and utilization management , proactive patient management , care facilitation and ... be a licensed RN in NYS; BSN preferred. 3-5 years professional nursing experience. Progressive clinical experience including community health, care management ,… more
    Highland Hospital (06/28/25)
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  • MDS Coordinator

    Elderwood (Hamburg, NY)
    …Federal and State requirements, and facility policies. + Actively participate in utilization management processes, including PDPM and state case mix process. ... Hour Overview Elderwood at Hamburg is seeking a Registered Nurse (RN) to join our clinical team as a...health and well-being of residents in Medicare- or Medicaid-certified nursing homes. Following federally-mandated procedures and using the MDS… more
    Elderwood (08/02/25)
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  • Patient Care Coordinator

    Kaleida Health (Williamsville, NY)
    …with members of the interdisciplinary team to coordinate care, facilitate utilization and resource management and discharge planning functions, working ... Current New York State registration as a Registered Professional Nurse required. Bachelor of Science degree in Nursing...2 years of experience in any combination of case management , home care and utilization review preferred.… more
    Kaleida Health (06/19/25)
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  • Admission Coordinator

    Sodus Rehab & Nursing Center (Utica, NY)
    …concurrent review package. + . Submitting concurrent review package and follow up with Utilization Management team at the Managed Care Plan for status. + . ... responsible for all functions in relations to admissions into the Healthcare Nursing Center. The admissions Coordinator is directly responsible for ensuring all… more
    Sodus Rehab & Nursing Center (06/24/25)
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