• Supervisor, Health Insur & Auth

    University of Rochester (Rochester, NY)
    …to integrate operations with other components of URMC, such as Financial Case Management , RIM, Utilization Management , Social Work, Patient Accounts, Medical ... Finance, and Legal. + Serves as a liaison to patients, physicians, nursing , social workers, other URMC staff, insurance companies. Serves on committees/teams as… more
    University of Rochester (08/07/25)
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  • Behavioral Health Care Manager II

    Elevance Health (Latham, NY)
    …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... work counseling or a related behavioral health field or a degree in nursing , and minimum of 3 years of experience with facility-based and/or outpatient psychiatric… more
    Elevance Health (07/02/25)
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  • Care Review Clinician, Inpatient Review (RN)

    Molina Healthcare (Rochester, NY)
    …Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina ... QUALIFICATIONS** **Required Education** Graduate from an Accredited School of Nursing . **Required Experience** 3+ years hospital acute care/medical experience.… more
    Molina Healthcare (08/03/25)
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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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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (New York, NY)
    …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... discharge planning + Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members and their families… more
    Centene Corporation (08/02/25)
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  • AVP, Clinical Operations, MHI

    Molina Healthcare (Albany, NY)
    …or equivalent combination of education and experience **Required Experience** 7 years of utilization and/or case management experience 7 years management ... Health Administration, MBA with Healthcare emphasis) **Preferred Experience** 10 years of utilization and/or case management experience 10 years management more
    Molina Healthcare (08/13/25)
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  • Director of Patient Services, Homecare RN - Hapi

    The New Jewish Home (Bronx, NY)
    …informed of the latest internal and external issues and trends in utilization and quality management through select committee participation, networking, ... all clinical operations, performance improvement activities, training and supervision of nursing and field staff and medical compliance issues. Reports To: AVP,… more
    The New Jewish Home (06/25/25)
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  • RN Case Manager - Case Management - Full…

    Guthrie (Corning, NY)
    … (BSN) or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing . A registered nurse with five (5) years relevant experience willing to pursue a ... and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates… more
    Guthrie (06/24/25)
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  • Developmental Assistant Tr/1

    New York State Civil Service (Brooklyn, NY)
    …DDSO internal operational systems including but not limited to attendance, staff utilization , incident management , upkeep of physical plant, fire safety ... Developmental Disabilities Secure Care Treatment Aide 1, or Licensed Practical Nurse , and completion of a one-year traineeship.The position may be filled… more
    New York State Civil Service (08/08/25)
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  • Nurse Practitioner-Cardiothoracic- Mount…

    Mount Sinai Health System (New York, NY)
    …or appropriately credentialed designee. + Ability to interpret and apply principles of nursing research utilization . + Ability to manage and coordinate a patient ... **Job Description** **Job Title : Nurse Practitioner- Cardiothoracic- Mount Sinai Hospital - Full...designee. + Ability to interpret and apply principles of nursing research utilization . + Ability to manage… more
    Mount Sinai Health System (08/03/25)
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