• RN/Case Manager-MSH-Case Management

    Mount Sinai Health System (New York, NY)
    …to: a Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using standardized ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will...Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or… more
    Mount Sinai Health System (07/15/25)
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  • Director of Case Management

    Stony Brook University (Stony Brook, NY)
    …Coordinate the design, development, implementation, and monitoring of the organization's case management and utilization review functions. + Lead initiatives ... Management leadership and staff functions related to case management and utilization management activities....and collaboration with Social Work Services * Knowledge of Utilization Review and Denial/Appeals * Knowledge of… more
    Stony Brook University (08/08/25)
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  • Case Manager- Case Management

    Arnot Health (Elmira, NY)
    …related to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. ... nursing program with a current license as a registered nurse . BSN or Case Management Certification preferred....nursing in acute care hospital setting or two years utilization management in an acute care hospital… more
    Arnot Health (08/08/25)
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  • RN Supervisor Case Management - Full Time…

    Mohawk Valley Health System (Utica, NY)
    …population. Provides direct oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member ... - SNH is responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties include… more
    Mohawk Valley Health System (07/09/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates… more
    Guthrie (05/13/25)
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  • Director of Nursing Professional Practice, RN…

    Mount Sinai Health System (New York, NY)
    …the Daily Management Board process/practice improvement activities to facilitate the utilization of evidence and data related to Nurse Sensitive Indicators ... **Job Description** The Director of Nursing Professional Practice is a professional nurse with broad knowledge and skill in the professional practice standards, NYS… more
    Mount Sinai Health System (07/15/25)
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  • Director of Care Management - Mount Sinai…

    Mount Sinai Health System (Long Island City, NY)
    **Job Description** The Director will direct and manage departmental activities involved in utilization review , appeals management and discharge planning to ... or healthcare-related field **Experience Requirements** 5 years of Case Management and 6 years of clinical nurse ...services by focusing on patient processes. 8.Develops and implements Utilization Review (UR) based on internal data… more
    Mount Sinai Health System (07/24/25)
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  • RN Case Manager - Case Management - Full…

    Guthrie (Corning, NY)
    …Has an understanding of the regulatory requirements relative to the case management process. Certified to complete Patient Review Instruments (PRIs). Has ... 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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  • Medical Director (Marketplace)

    Molina Healthcare (Albany, NY)
    … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
    Molina Healthcare (08/08/25)
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  • Care Facilitator- Per Diem- Canton-Potsdam…

    Rochester Regional Health (Rochester, NY)
    …in the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization , performing continued stay reviews ... efficient utilization of resources. Carries out activities related to utilization management , discharge planning, care coordination and referral to other… more
    Rochester Regional Health (07/25/25)
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