• Care Review Clinician, PA ( RN )

    Molina Healthcare (Rochester, NY)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
    Molina Healthcare (09/05/25)
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  • Care Facilitator

    Rochester Regional Health (Rochester, NY)
    …State as a Registered Nurse PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience + Bachelor's Degree EDUCATION: LICENSES ... Support - American Heart Association (AHA)American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education… more
    Rochester Regional Health (09/18/25)
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  • Registered Nurse Care…

    Catholic Health (Buffalo, NY)
    …degree or RN with BSW, BS Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York State + New York State PRI & ... and families in the hospital setting. Utilizing foundational case management and discharge planning principles, the RN ...BS Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York… more
    Catholic Health (09/25/25)
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  • Case Manager, RN (Commercial)

    Excellus BlueCross BlueShield (Rochester, NY)
    …and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory ... varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist,… more
    Excellus BlueCross BlueShield (09/30/25)
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  • RN Clinical Appeals Nurse

    Molina Healthcare (Yonkers, NY)
    …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
    Molina Healthcare (09/26/25)
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  • Care Coordinator RN TRI PC Orchard Park

    Catholic Health (West Seneca, NY)
    …Degree in Nursing required + Current, unrestricted licensure by New York State as a Registered Nurse ( RN ) required EXPERIENCE + Minimum of (1) year ... experience as a registered nurse required + One (1) year previous case, disease, or utilization management experience preferred + One (1) year previous… more
    Catholic Health (09/04/25)
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  • Manager, Healthcare Services

    Molina Healthcare (Buffalo, NY)
    …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational… more
    Molina Healthcare (09/27/25)
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  • Care Facilitator- Per Diem- Canton-Potsdam…

    Rochester Regional Health (Rochester, NY)
    …Support - American Heart Association (AHA)American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education ... utilization of resources. Carries out activities related to utilization management , discharge planning, care coordination and...required + Licensed in New York State as a Registered Nurse + For hires after 10/28/2024,… more
    Rochester Regional Health (07/25/25)
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  • Registered Nurse II, Acute Care…

    Bassett Healthcare (Cooperstown, NY)
    …experience as a Registered Nurse , if experience is not relevant, Registered Nurse II must complete RN residency program, required License/ ... Certification: + Current NYS license as a Registered Nurse , required + BLS certification will...or be suspended at any time. Bonus Amount: + RN (excluding management ) sign-on bonuses are awarded… more
    Bassett Healthcare (09/25/25)
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  • Registered Nurse - Golisano…

    Rochester Regional Health (Rochester, NY)
    …Full Time (36 hours per week)Schedule: Evening/Nights, rotating weekends and holidays SUMMARY:As a Registered Nurse ( RN ), you're the engine and the heart of ... to brain trauma and/or generalized deconditioned status. Our coma management program offers the best in medical and rehabilitative...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
    Rochester Regional Health (07/12/25)
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