• Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …from payors for additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as ... accredited Nursing School or College; current New York State, RN License required, BSN Bachelor of Science in Nursing...current with industry standards and business objectives related to Utilization and Care Management as appropriate. +… more
    Catholic Health Services (07/24/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Binghamton, NY)
    …recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in collaboration with ... degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant...admissions and short procedures by translating clinical information to Utilization Management requirements using pre‐determined criteria. b.… more
    Guthrie (08/27/25)
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  • Assistant Director of Case Management

    Stony Brook University (Stony Brook, NY)
    …the following but are not limited to:** + Responsible for addressing Utilization management , denials and appeal, discharge and transition planning activities, ... Management leadership and staff functions regarding care management and utilization management activities....Qualifications:** * Possession of license to practice as a registered nurse in New York State. *… more
    Stony Brook University (09/23/25)
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  • Care Manager ( Registered Nurse

    Catholic Health Services (Port Jefferson, NY)
    …+ 3+ Years acute care clinical RN experience required + Prior RN experience in Utilization Management , Performance Improvement, Transition Planning ... the acute care continuum. + Perform required activities for utilization management , PRI assessment and completion, transition...a BSN program may apply + Licensure: New York Registered Nurse ( RN ) License &… more
    Catholic Health Services (09/29/25)
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  • Registered Nurse Case Manager…

    Northwell Health (Staten Island, NY)
    **Req Number** 167724 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality ... + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria +… more
    Northwell Health (09/17/25)
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  • Case Manager RN

    Bassett Healthcare (Oneonta, NY)
    …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... barriers to efficient delivery of care in appropriate setting. + Completes utilization management and quality screening for assigned patients. + Applies… more
    Bassett Healthcare (09/18/25)
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  • Transitional Care RN - Case…

    Mohawk Valley Health System (Utica, NY)
    …+ 3 years of clinical experience. + Strong computer skills. PREFERRED: + Case Management , Utilization Management and Quality Management experience ... Transitional Care RN - Case Management - Full...Licensure/Certification Requirements REQUIRED: + Current NYS Licensed Registered Professional Nurse . Disclaimer Qualified applicants will… more
    Mohawk Valley Health System (07/09/25)
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  • Registered Nurse Case Manager

    Northwell Health (Sleepy Hollow, NY)
    …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + ... Submits data to management regarding case management and/or quality initiatives....entry date. + Current License to practice as a Registered Professional Nurse in New York State… more
    Northwell Health (09/29/25)
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  • Registered Nurse ( RN )…

    Rochester Regional Health (Rochester, NY)
    …Schedule: Straight Shift- Days. Every other weekend/holidays. Sign-On Bonus: $15,000 SUMMARY: As a Registered Nurse ( RN ), you're the engine and the heart of ... on 3800 provide direct bedside care, patient education, pain management , post-op recovery support, and discharge planning. The unit...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
    Rochester Regional Health (08/16/25)
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  • VP Care Management Post-Acute Care…

    Kaleida Health (Buffalo, NY)
    …preferred. RN licensure required.** **Experience** **10 years of care management / utilization management experience required in hospital and/or ambulatory ... **VP Care Management Post-Acute Care Transition** **Location:** **Buffalo General Medical...**The Vice President (VP) role supports the system Chief Nurse Executive (CNE) in providing executive leadership and guidance… more
    Kaleida Health (09/17/25)
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