• Utilization Management Reviewer,…

    Excellus BlueCross BlueShield (Rochester, NY)
    …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
    Excellus BlueCross BlueShield (10/07/25)
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  • Supervisor, Utilization Management

    Centene Corporation (New York, NY)
    …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... perspective on workplace flexibility. **Must have an active New York State RN license.** **Inpatient Utilization Management ** **Position Purpose:**… more
    Centene Corporation (11/09/25)
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  • Utilization Management Reviewer,…

    Excellus BlueCross BlueShield (Rochester, NY)
    …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
    Excellus BlueCross BlueShield (11/19/25)
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  • Utilization Management Clinical…

    CVS Health (Albany, NY)
    …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… more
    CVS Health (11/19/25)
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  • Utilization Management Nurse

    CVS Health (Albany, NY)
    …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and...**Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care… more
    CVS Health (11/20/25)
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  • RN Utilization Management

    Trinity Health (Troy, NY)
    …often lead to innovative solutions. ** Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme TRACK weekends** ... If you are looking for an RN position in Case Management and a...accommodate all schedules **What you will do:** + Perform utilization management , both concurrent and retroactive for… more
    Trinity Health (11/07/25)
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  • Utilization Management Nurse

    Humana (Albany, NY)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...Qualifications** + Minimum of an Associate's degree + Licensed Registered Nurse ( RN ) with no… more
    Humana (11/18/25)
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  • Utilization Management Nurse

    Humana (Albany, NY)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
    Humana (11/16/25)
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  • Clinical Registered Nurse

    Cognizant (Albany, NY)
    …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
    Cognizant (11/15/25)
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  • Utilization Management Nurse

    CVS Health (Albany, NY)
    …with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management opportunity for RNs with a **New York** state licensure. ... Friday, 8:30am - 5pm EST. This role is a registered nurse that utilizes MCG rules and...unrestricted New York state licensure + 1+ year of Utilization review experience + 1+ year of clinical experience… more
    CVS Health (10/24/25)
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