• Manager, Utilization Management

    Centene Corporation (New York, NY)
    …+ Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact State ... Review Clinical Review team to ensure appropriate care to members. Manages utilization management issues related to member care, provider interactions, and… more
    Centene Corporation (05/15/25)
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  • Utilization Management

    Crouse Hospital (Syracuse, NY)
    …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data ... occasional weekends (typically requires 6 weekends a year). Utilization Management Registered Nurse ( RN ) Position Responsibilities: + Works… more
    Crouse Hospital (03/20/25)
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  • Utilization Management

    Veterans Affairs, Veterans Health Administration (Buffalo, NY)
    …Buffalo Location. The Nurse Utilization Management (UM) Registered Nurse ( RN ) executes position responsibilities that demonstrate leadership, ... seeking a Utilization Management (UM) Registered Nurse ( RN ) to work...Nurse Utilization Management (UM) Registered Nurse ( RN ) executes position… more
    Veterans Affairs, Veterans Health Administration (05/14/25)
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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, ... **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing… more
    CVS Health (05/18/25)
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  • Utilization Management RN

    Ellis Medicine (Schenectady, NY)
    Basic Function: The Utilization Management Registered Nurse (UM RN ) supports daily coordination of care across healthcare continuum with the ... preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN...care related field required. Current registration as a Licensed Registered Professional Nurse in New York State.… more
    Ellis Medicine (04/03/25)
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  • Utilization Management Nurse

    CVS Health (Albany, NY)
    …day. This is a full-time remote position. **Position Summary** Precertification (Infertility): Utilization Management Nurse Consultant + Utilizes clinical ... management function. **Required Qualifications** + 3+ years of acute experience as a Registered Nurse + Must have active current and unrestricted RN more
    CVS Health (05/17/25)
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  • Assistant Director of Case Management

    Mount Sinai Health System (New York, NY)
    …and efficient care to patients, the delivery of comprehensive front-line Case Management services, including utilization management , care facilitation and ... field, Master's degree preferred + 5 years of Case Management and 6 years as a clinical nurse... management is preferred Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West… more
    Mount Sinai Health System (04/04/25)
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  • Utilization Management Nurse

    CVS Health (Albany, NY)
    …And we do it all with heart, each and every day. Requisition Job Description Utilization Management is a 24/7 operation and work schedule may include weekends ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...**Required Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current… more
    CVS Health (05/16/25)
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  • RN Utilization Review - System Care…

    Guthrie (Binghamton, NY)
    …necessary. Oversees and coordinates compliance to federally mandated and third party payer utilization management rules and regulations The pay range for this ... Provides health care services regarding admissions, case management , discharge planning and utilization review. Responsibilites: Reviews admissions and service… more
    Guthrie (04/05/25)
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  • Utilization Management Nurse

    CVS Health (Albany, NY)
    …is a fully remote position. The requirements is for candidates to hold a **New York Registered Nurse ** License. This employee will work four - 10 hour days per ... with heart, each and every day. **Position Summary** This ** Utilization Manager** position is with Aetna's Long-Term Services and...week. This role is a registered nurse that utilizes MCG rules and… more
    CVS Health (05/15/25)
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