• Clinical Denials and Appeals-Clinical Supervisor

    Catholic Health (Buffalo, NY)
    …(the payers) and internal stakeholders including, but not limited to, Utilization Review, Case Management , Clinical Documentation Integrity, Health Information ... (CPMA), Certified Case Manager (CCM) or any other certification approved by management + Certification in a Nationally Recognized Utilization Review Criteria… more
    Catholic Health (10/01/25)
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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 (09/26/25)
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  • Financial Clearance Center Representative

    Catholic Health Services (Melville, NY)
    …initiated within 24 hours of admission / arrival. + Coordinate with onsite Case Management and Utilization Management to guarantee payer requirements are met ... has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a...Utilize work queues/work drivers and reports as assigned by management , to complete daily tasks. + Confirm that a… more
    Catholic Health Services (09/13/25)
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  • Staff Nurse CMH ER, .9 FT, 7pm - 7am

    UHS (Norwich, NY)
    …Health Services policy + Shares responsibility for productivity and effective resource utilization including staffing, time management , supplies, and services + ... Position OverviewThe Registered Nurse (RN) or Graduate Nurse (GN)...Responsibilities: + Assesses, plans, delegates, coordinates, implements, and evaluates nursing care for a group of patients, serving as… more
    UHS (09/30/25)
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  • Social Work Care Manager

    Elderwood (Buffalo, NY)
    …may require interventions. + Participate in Interdisciplinary Team meetings, Disease Management , Utilization Management , and Quality Improvement activities ... Work Care Manager, you will partner with the Registered Nurse and are a critical resource for our members...related issues + Provide discharge planning and continuous care management across care settings and coordinate the transition planning… more
    Elderwood (08/16/25)
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  • Authorization Coordinator

    Catholic Health Services (Melville, NY)
    …and accurate according to payer requirements. The role will work closely with Utilization Management , Patient Accounts, and other key stakeholders in the revenue ... has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a...necessity. + Utilize WQs and reports, as assigned by management , to ensure completion of financial clearance functions for… more
    Catholic Health Services (10/03/25)
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  • Sup, Health Insurance & Prior Authorization Coords

    University of Rochester (Rochester, NY)
    …such as Medicaid Enrollment & Outreach, Financial Assistance, Registration and Insurance Management , Utilization Management , Social Work, Patient Accounts, ... external review agencies. + Serves as a liaison to patients, physicians, nursing , social workers, other URMC staff, insurance companies; serves on committees/teams… more
    University of Rochester (09/19/25)
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  • Mobile Professional Care Manager (Hybrid)

    UPMC (Jamestown, NY)
    …. + Minimum of 3 years of experience in behavioral health, clinical care, utilization management , home care, discharge planning, or case management . + ... 5 years of experience in community-based case management and behavioral health _preferred_ . + General knowledge of best practices for working with special needs… more
    UPMC (08/30/25)
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  • Behavioral Health Care Manager II

    Elevance Health (New Hyde Park, NY)
    …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... offers superior clinical mental health and substance use disorder management , a comprehensive employee assistance program, work/life support, specialty programs… more
    Elevance Health (09/30/25)
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  • Leader, Concurrent Review

    MVP Health Care (Schenectady, NY)
    …4 years of clinical nursing experience. + At least 2 years in utilization management sub-acute care review. + 2+ years of supervisory experience + Strong ... Associate or bachelor's degree in nursing (BSN preferred). + Minimum...team at ###@mvphealthcare.com . **Job Details** **Job Family** **Medical Management /Clinical** **Pay Type** **Salary** **Hiring Min Rate** **56,200 USD**… more
    MVP Health Care (10/05/25)
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