• 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 ... Full Time: 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse ( RN ) Position Responsibilities: + Works collaboratively… more
    Crouse Hospital (09/25/25)
    - Related Jobs
  • RN , Manager, Utilization

    Humana (Albany, NY)
    …areas. **Use your skills to make an impact** **Required Qualifications** + An active, unrestricted Registered Nurse ( RN ) license in the state of Michigan. + ... of our caring community and help us put health first** The Manager, Utilization Management Nursing (LTSS Utilization Management Leader) utilizes clinical… more
    Humana (09/28/25)
    - Related Jobs
  • 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, ... + **MUST LIVE IN EASTERN STANDARD TIME ZONE** + 4-5 years of experience as a Registered Nurse in adult acute care, critical care , emergency or med/surg setting… more
    CVS Health (09/27/25)
    - Related Jobs
  • RN Utilization Management

    Trinity Health (Albany, NY)
    …often lead to innovative solutions. ** Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme Days** 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 (09/30/25)
    - Related Jobs
  • Utilization Management Nurse

    Humana (Albany, NY)
    …a part of our caring community and help us put health first** The Weekend 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 (09/26/25)
    - Related Jobs
  • Clinical Learning Facilitator - Utilization

    Molina Healthcare (Buffalo, NY)
    …state board licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/behavioral health settings. + One year of ... or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in Health Care… more
    Molina Healthcare (09/17/25)
    - Related Jobs
  • 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 (07/05/25)
    - Related Jobs
  • Utilization Manager Reviewer, RN

    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 (08/23/25)
    - Related Jobs
  • Utilization Review Nurse

    Independent Health (Buffalo, NY)
    …Degree in Nursing required; Bachelor's degree preferred. Current, active, unrestricted, and licensed registered nurse ( RN ) required. + Two (2) years of ... Collaborative and Accountable. **Essential Accountabilities** Provide High Quality, Professional Utilization Management Services: (Medical necessity review for… more
    Independent Health (09/25/25)
    - Related Jobs
  • Utilization Review Nurse

    CDPHP (Latham, NY)
    …Minimum two (2) years of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York… more
    CDPHP (09/23/25)
    - Related Jobs